Gutierrez I Z, Barone D L, Currier C, Makula P A
J Vasc Surg. 1985 May;2(3):468-71. doi: 10.1067/mva.1985.avs0020468.
Three cases of infragenicular femoropopliteal bypass grafts are presented in which iatrogenic entrapment of the distal portion of the graft occurred between the medial head of the gastrocnemius muscle and the posterior surface of the tibia. The condition should be suspected if ischemia of the leg develops postoperatively when the knee is hyperextended and is improved when the knee joint is flexed. Measurements of the ankle pressure index or Pulse Volume Recorder tracings at the ankle in both flexed and extended positions will confirm the diagnosis. The entrapment of the bypasses in these three patients was easily corrected by transection of the medial head of the gastrocnemius muscle. Relief of the occlusion of the bypass can be easily demonstrated by noninvasive studies.
本文报告3例膝下股腘动脉搭桥移植病例，其移植物远端发生医源性卡压，位于腓肠肌内侧头与胫骨后表面之间。如果术后膝关节过度伸展时出现腿部缺血，而膝关节屈曲时症状改善，则应怀疑这种情况。在膝关节屈曲和伸展位测量踝压指数或踝部脉搏容积记录图将证实诊断。这3例患者的搭桥移植物卡压通过切断腓肠肌内侧头很容易得到纠正。通过无创检查可以很容易地证实搭桥闭塞得到缓解。
