Canepa C S, Schubart P J, Taylor L M, Porter J M
Surgery. 1987 Mar;101(3):323-8.
Increasing numbers of patients with aortoiliac disease are seen with contraindications to standard infrarenal aortofemoral reconstruction. Although axillofemoral bypass is possible in these patients, the decreased patency rate associated with this operation makes alternate procedures desirable. This report details our experience with prosthetic bypass from the supraceliac aorta to the femoral arteries in seven patients with limb-threatening ischemia of the lower extremity, all of whom had undergone multiple previous aortic operations. The operations were performed through thoracoabdominal or flank incision, and the preferred graft configuration consisted of a single Dacron tube from the aorta to the left groin with a standard subcutaneous femorofemoral graft to the right groin. No surgical deaths occurred. At 3 1/2 years' mean follow-up, there has been one graft limb occlusion that resulted in amputation for an overall life table patency and limb salvage rate of 93%. We conclude that supraceliac to femoral artery bypass is a useful procedure for the treatment of patients who have had multiple previous aortic reconstructions fail.
越来越多患有主髂动脉疾病的患者存在标准肾下腹主动脉-股动脉重建术的禁忌证。尽管这些患者可行腋-股动脉旁路移植术，但该手术相关的通畅率降低使得其他替代手术成为必要。本报告详细介绍了我们对7例下肢存在威胁肢体缺血的患者进行从腹主动脉上段至股动脉的人工血管旁路移植术的经验，所有这些患者此前均接受过多次主动脉手术。手术通过胸腹联合切口或侧腹壁切口进行，首选的移植物构型为由主动脉至左腹股沟的单根涤纶人工血管，并通过标准的皮下股-股人工血管连接至右腹股沟。无手术死亡病例。平均随访3.5年时，有1例人工血管肢体闭塞导致截肢，总体生命表通畅率和肢体挽救率为93%。我们得出结论，腹主动脉上段至股动脉旁路移植术对于既往多次主动脉重建术失败的患者是一种有效的治疗方法。
