Pietri P, Adovasio R, Alagni G
Minerva Chir. 1979 Feb 28;34(4):229-34.
The factors underlying late thrombosis of aortobifemoral by-pass are analysed on the basis of personal experience and reported data. They are considered to be due to progressive degradation of the prosthesic tissue and, particularly, to the lack of an adequate back flow route, apart from any faults in the actual construction of the femoral anastomosis. Treatment of the thrombotic complication involves considerable technical and operating problems which have two main solutions: substitution of the thrombosed branch, or its disobstruction. Intimately linked with restoral of by-pass patency is the reconstruction of an adequate back flow route either by means of profundaplasty or by extending the branch as far as popliteal level. Of 83 patients discharged with patent prosthesis, thrombosis occurred in 7 and 10 reoperations were necessary. Reconstruction of branch patency was done in the majority of cases by thrombectomy. Profundaplasty was associated in 4 cases while in other 4 popliteal extension was necessary. Analysis of results shows that the operation of choice on the affluxion route seems to be replacement of the thrombosed branch.
基于个人经验和已报道的数据，对主-双股动脉旁路移植术后晚期血栓形成的潜在因素进行了分析。除了股动脉吻合口实际构建中存在的任何缺陷外，这些因素被认为是由于人工血管组织的渐进性退化，特别是缺乏足够的反流途径所致。血栓形成并发症的治疗涉及相当多的技术和手术问题，主要有两种解决方法：置换血栓形成的分支或解除其阻塞。与恢复旁路通畅密切相关的是通过股深动脉成形术或延伸分支至腘动脉水平来重建足够的反流途径。在83例人工血管通畅出院的患者中，7例发生血栓形成，需要进行10次再次手术。在大多数情况下，通过血栓切除术重建分支通畅。4例联合股深动脉成形术，另外4例需要腘动脉延伸。结果分析表明，对于流入途径的首选手术似乎是置换血栓形成的分支。
