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在胸腹主动脉置换术中使用大隐静脉重新植入肋间动脉。

Use of saphenous vein to reimplant intercostal arteries during thoraco-abdominal aortic replacement.

作者信息

Idhrees Mohammed, Kasturi Srikanth, Kumar Arun, Velayudhan Bashi

机构信息

Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Vadapalani, Chennai 600026 India.

出版信息

Indian J Thorac Cardiovasc Surg. 2025 Jan;41(1):41-44. doi: 10.1007/s12055-024-01776-9. Epub 2024 Jul 2.

Abstract

Spinal cord ischemia (SCI) is a major debilitating complication of thoraco-abdominal aortic aneurysm (TAAA) repair, even in experienced centers. Several strategies are employed to reduce the incidence of SCI and the resultant paraplegia, yet the optimum method is unknown. We describe our experience of using the reversed saphenous vein graft (RSVG) as a conduit to reimplant the intercostal arteries (ICAs). We aimed to assess the incidence of SCI when using RSVG in TAAA repair. Eight consecutive patients who underwent elective surgical replacement of the thoraco-abdominal aorta were studied. The mean age of our patients was 48.9 ± 12.1 years with 87.5% being males. A mean of 3.25 ICAs were reimplanted in each patient. No patient developed postoperative SCI or wound complications related to saphenous vein (SV) harvesting. RSVG patency at 3 months was 84.61%. Though the long-term results of this technique are still unknown, this technique is a beneficial and handy alternative without compromising the blood flow to the ICAs.

摘要

脊髓缺血(SCI)是胸腹主动脉瘤(TAAA)修复术后一种严重的致残性并发症,即使在经验丰富的中心也是如此。人们采用了多种策略来降低SCI的发生率及由此导致的截瘫,但最佳方法尚不清楚。我们描述了使用大隐静脉移植反转术(RSVG)作为肋间动脉(ICA)再植的管道的经验。我们旨在评估在TAAA修复中使用RSVG时SCI的发生率。对连续8例接受择期胸腹主动脉置换手术的患者进行了研究。我们患者的平均年龄为48.9±​12.1岁,87.5%为男性。每位患者平均再植3.25支ICA。没有患者发生与大隐静脉(SV)采集相关的术后SCI或伤口并发症。3个月时RSVG通畅率为84.61%。尽管该技术的长期结果尚不清楚,但该技术是一种有益且方便的替代方法,不会影响ICA的血流。

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