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舟状静脉袖套技术在外周动脉旁路移植术中的手术效果

Surgical Outcomes of the Boat-Form Vein Cuff Technique in Peripheral Artery Bypass Grafting.

作者信息

Sakamoto Shun-Ichiro, Tsuji Anna, Maeda Motohiro, Hiromoto Atsushi, Suzuki Kenji, Honda Jiro, Ishii Yosuke

机构信息

Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, Kawasaki, Kanagawa, Japan.

Department of Cardiovascular Surgery, Nakagami Hospital, Okinawa, Okinawa, Japan.

出版信息

Ann Vasc Dis. 2025;18(1). doi: 10.3400/avd.oa.24-00134. Epub 2025 May 30.

Abstract

The venous cuff technique has been used primarily for arterial bypass using artificial grafts to the lower extremities. The boat-form vein cuff was designed to allow adjustment of the size and angle of the anastomosis at any anatomic site. We report our experience and outcomes of the original vein cuff technique in various peripheral artery bypass grafting procedures. A total of 10 patients underwent arterial bypass grafting using a polytetrafluoroethylene (PTFE) graft with a boat-form venous cuff. The indications for the surgery consisted of peripheral artery disease (n = 4), acute limb ischemia (n = 4), chronic mesenteric ischemia (n = 1), and traumatic upper limb ischemia (n = 1). Five patients required emergency surgery. Surgical outcomes, such as mortality and morbidity, limb salvage rate, and graft patency, were examined using perioperative and postoperative follow-up data. There were no operative deaths or serious complications, including amputation of the lower extremity. During the follow-up period (44 ± 36.9 months), the PTFE graft remained patent in 9 patients (90%). In 1 patient, occlusion of the femoropopliteal bypass graft was observed 3 months after surgery. The simple design and creation of the boat-form vein cuff are useful at any anatomical site in peripheral artery bypass grafting with a PTFE graft.

摘要

静脉袖套技术主要用于使用人工移植物对下肢进行动脉搭桥。船形静脉袖套的设计是为了能在任何解剖部位调整吻合口的大小和角度。我们报告了在各种外周动脉搭桥手术中应用原始静脉袖套技术的经验和结果。共有10例患者接受了使用带有船形静脉袖套的聚四氟乙烯(PTFE)移植物的动脉搭桥手术。手术适应证包括外周动脉疾病(4例)、急性肢体缺血(4例)、慢性肠系膜缺血(1例)和创伤性上肢缺血(1例)。5例患者需要急诊手术。利用围手术期和术后随访数据对手术结果,如死亡率和发病率、肢体挽救率和移植物通畅率进行了检查。没有手术死亡或严重并发症,包括下肢截肢。在随访期(44±36.9个月),9例患者(90%)的PTFE移植物保持通畅。1例患者在术后3个月观察到股腘动脉搭桥移植物闭塞。船形静脉袖套的简单设计和制作在使用PTFE移植物进行外周动脉搭桥的任何解剖部位都很有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2945/12129623/6f0769206774/avd-18-1-24-00134-figure01.jpg

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