Piccone V A, Ip M W, LeVeen H H
Arch Surg. 1978 Aug;113(8):951-5. doi: 10.1001/archsurg.1978.01370200045009.
Distal Y branches to other below-knee arteries were added to standard femorotibial bypass grafts to increase runoff, more effectively perfuse the ischemic limb, and improve limb salvage rate. Y grafts were performed in 16 lower limbs in 15 patients. Flow through the graft was increased significantly with each additional Y limb. Preoperative angiograms demonstrated filling of the distal vessels. Surgical indications were gangrenous toes or ischemic ulcers in 12 patients, and 13 limbs were saved. Three patients received bypass grafts for acute ischemic changes, limbs were salvaged in two of the three patients. Two Y grafts performed in 1971 and in 1974 remain patent. Between 1971 and 1977, forty standard femorotibial bypasses were done, with a long-term patency rate of 54%. During the past two years, 13 more Y grafts were performed, with an overall initial patency of 94%. Late results of the Y grafts have been surprisingly good, with no subsequent loss of grafts or limbs.
在标准股胫旁路移植术中增加至膝下其他动脉的远端Y形分支，以增加血流灌注、更有效地灌注缺血肢体并提高肢体挽救率。15例患者的16条下肢进行了Y形移植术。每增加一个Y形分支，通过移植血管的血流量显著增加。术前血管造影显示远端血管充盈。手术指征为12例患者出现坏疽性趾或缺血性溃疡，13条肢体得以挽救。3例患者因急性缺血性改变接受旁路移植术，其中2例患者的肢体得以挽救。1971年和1974年进行的2例Y形移植术仍保持通畅。1971年至1977年间，进行了40例标准股胫旁路移植术，长期通畅率为54%。在过去两年中，又进行了13例Y形移植术，总体初始通畅率为94%。Y形移植术的远期效果出奇地好，后续没有移植血管或肢体丢失。
