Gorey T F, Bulkley G B, Spees E K, Sterioff S
Ann Surg. 1979 Dec;190(6):753-7. doi: 10.1097/00000658-197912000-00015.
In order to assess the effect of iliac artery ligation on the distal extremity, the ten year experience of the Johns Hopkins renal transplantation program was reviewed. Among 467 transplant procedures in 390 patients there were six cases in which the common and/or external iliac artery had been ligated for control of untoward hemorrhage from an infected arteriotomy site. These six cases were studied in detail with particular attention to ischemic sequelae in the involved leg. There were no immediate or causally-related deaths. No patient lost a leg or required an immediate reconstructive procedure for limb salvage. Four of the six recovered ambulatory status, and only two of these required a later, elective reconstruction for claudication. The combination of these six with eight other similar patients previously reported provides a total of 14 cases of iliac artery ligation in renal transplant patients. No patient suffered actual limb loss, and only three underwent subsequent elective reconstruction for claudication. It is concluded that common and/or external iliac artery ligation without immediate revascularization may be performed for control of hemorrhage with little danger of limb loss in renal transplant patients.
为了评估髂动脉结扎对下肢的影响，回顾了约翰霍普金斯肾移植项目的十年经验。在390例患者的467例移植手术中，有6例为控制感染动脉切开部位的不良出血而结扎了髂总动脉和/或髂外动脉。对这6例病例进行了详细研究，特别关注受累下肢的缺血后遗症。没有立即死亡或与手术相关的死亡。没有患者失去下肢或需要立即进行重建手术以挽救肢体。6例中有4例恢复了行走状态，其中只有2例后来因跛行需要进行择期重建。这6例与之前报道的其他8例类似患者相结合，肾移植患者中共有14例髂动脉结扎病例。没有患者实际失去肢体，只有3例后来因跛行接受了择期重建。结论是，对于肾移植患者，为控制出血可在不立即进行血管重建的情况下结扎髂总动脉和/或髂外动脉，肢体丧失的风险很小。
