Takahashi Goro, Saiki Yoshikatsu
Department of Cardiovascular Surgery, Tohoku University, Sendai, Japan.
Kyobu Geka. 2024 Sep;77(10):754-760.
The axillary artery and femoral artery and vein have much versatility for cardiovascular surgeons among the peripheral vessels that can be exposed, and they are able to be cannulated and anastomosed safely. They can be used for inflow or drainage line for extracorporeal circulation, approach site for impeller insertion, thoracic endovascular aortic repair( TEVAR) and transcatheter aortic valve replacement (TAVR). Therefore, it is important to establish a systematic exposure method for these vessels. The axillary artery has complex surrounding tissues, and unusual anatomical vessels reported in Japanese patients. A thorough understanding of its anatomy should be obtained to manipulate these vessels comfortably. The femoral artery is the most frequently used peripheral vessel, because it is relatively easy to expose. However, the difficulty may increase when exposing it in a semi-supine position taken in thoracoabdominal aortic aneurysm repair or minimal invasive cardiac surgery. The individual anatomical conditions of the femoral artery and vein should be assessed by preoperative computed tomography (CT) and intraoperative echocardiography to ensure an appropriate approach.
在可暴露的外周血管中，腋动脉、股动脉及股静脉对心血管外科医生而言具有多种用途，并且能够安全地进行插管和吻合。它们可用于体外循环的流入或引流管路、叶轮置入的入路部位、胸主动脉腔内修复术（TEVAR）及经导管主动脉瓣置换术（TAVR）。因此，为这些血管建立一种系统的暴露方法很重要。腋动脉周围组织复杂，且有日本患者报道过其存在不寻常的解剖血管。应深入了解其解剖结构，以便能自如地操作这些血管。股动脉是最常用的外周血管，因为它相对容易暴露。然而，在胸腹主动脉瘤修复术或微创心脏手术中采用半仰卧位暴露股动脉时，难度可能会增加。术前应通过计算机断层扫描（CT）及术中超声心动图评估股动脉和股静脉的个体解剖情况，以确保采用合适的入路。
