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聚四氟乙烯与人体脐静脉用于股腘动脉搭桥手术的随机临床试验。初步结果。

A randomized clinical trial of PTFE versus human umbilical vein for femoropopliteal bypass surgery. Preliminary results.

作者信息

Eickhoff J H, Buchardt Hansen H J, Brommé A, Ericsson B F, Kordt K F, Mouritzen C, Myhre H O, Norgren L, Rostad H, Trippestad A

出版信息

Br J Surg. 1983 Feb;70(2):85-8. doi: 10.1002/bjs.1800700210.

Abstract

PTFE (Goretex) and modified human umbilical vein (Biograft) vascular grafts were compared in femorodistal popliteal artery bypass surgery in a randomized clinical multicentre trial. During 18 months 104 patients (104 limbs) entered the trial. Twenty-five patients suffered from claudication, 54 suffered rest pain and 25 patients had ulceration or gangrene. The median preoperative ankle-arm blood pressure index was 0 . 34. Twenty-three limbs had 3 patent tibial arteries, 45 limbs had 2 tibial arteries, 31 limbs had 1 tibial artery while 5 limbs had an isolated popliteal segment. Thirty-six of the operations were redo-operations. Fifty-four patients were allocated to PTFE and 50 to umbilical vein. During follow-up (maximum 650 days) 24 PTFE grafts occluded against 12 umbilical veins. The 1-year patency rate was 40 per cent in the PTFE group against 75 per cent in the umbilical vein group (P = 0 . 014, Gehans test). During the first year the PTFE failure rate was on average 3 . 1 times higher than that of the umbilical vein.

摘要

在一项随机临床多中心试验中,对聚四氟乙烯(戈尔特斯)和改良人脐静脉(生物移植)血管移植物在股腘动脉旁路手术中的应用进行了比较。在18个月期间,104例患者(104条肢体)进入试验。25例患者患有间歇性跛行,54例患者有静息痛,25例患者有溃疡或坏疽。术前踝臂血压指数中位数为0.34。23条肢体有3条胫动脉通畅,45条肢体有2条胫动脉通畅,31条肢体有1条胫动脉通畅,而5条肢体仅有腘动脉段。36例手术为再次手术。54例患者被分配接受聚四氟乙烯移植物,50例接受脐静脉移植物。在随访期间(最长650天),24条聚四氟乙烯移植物闭塞,而脐静脉移植物有12条闭塞。聚四氟乙烯组1年通畅率为40%,脐静脉组为75%(P = 0.014,盖汉检验)。在第一年,聚四氟乙烯的失败率平均比脐静脉高3.1倍。

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