Devolfe C, Adeleine P, Henrie M, Violet F, Descotes J
J Cardiovasc Surg (Torino). 1983 Nov-Dec;24(6):634-40.
Experience with 131 crossover arterial bypass grafts for lower limb revascularization has been reviewed. Ninety-nine grafts were placed as a primary procedure for unilateral iliac artery occlusive (97) or aneurysmal (2) disease. In contrast 32 grafts were placed as a secondary procedure following the failure of a previous unilateral or bilateral conventional aorto-iliac reconstruction. Fifteen patients were not suitable for a crossover procedure without the addition of a concomitant donor limb inflow reconstruction. The one month operative mortality rate was 6.1%. The five-year cumulative patency rate was 71.4% +/- 6.0 in primary procedures and 38.1% +/- 11.3 in secondary procedures (p less than 0.05). No difference in the success rate was shown when the vein graft patency curve was compared with the synthetic graft patency curve. However, the use of a small caliber vein (6 mm or less) resulted in the lowest patency rate. No other factors affecting patency were found. This report tends to support the fact that ilio-femoral or femoro-femoral crossover bypass is a safe and effective procedure for managing unilateral iliac artery occlusive disease. With proper selection of patients, a wider use of the method is justified.
对131例用于下肢血管重建的交叉动脉搭桥术的经验进行了回顾。99例搭桥术作为单侧髂动脉闭塞性疾病（97例）或动脉瘤性疾病（2例）的一期手术进行。相比之下，32例搭桥术是在先前单侧或双侧传统主动脉-髂动脉重建失败后作为二期手术进行的。15例患者在未加用供体肢体流入道重建的情况下不适合进行交叉手术。手术1个月时的死亡率为6.1%。一期手术的5年累积通畅率为71.4%±6.0%，二期手术为38.1%±11.3%（p<0.05）。比较静脉移植物通畅曲线和人工合成移植物通畅曲线时，成功率无差异。然而，使用小口径静脉（6mm或更小）导致通畅率最低。未发现其他影响通畅的因素。本报告倾向于支持以下事实，即髂股或股股交叉搭桥术是治疗单侧髂动脉闭塞性疾病的一种安全有效的方法。通过适当选择患者，该方法有更广泛应用的合理性。
