Pierce G E, Turrentine M, Stringfield S, Iliopoulos J, Hardin C A, Hermreck A S, Thomas J H
Arch Surg. 1982 Dec;117(12):1580-8. doi: 10.1001/archsurg.1982.01380360056009.
The cumulative graft-limb patency rate was significantly higher after aortobifemoral bypass with a proximal end-to-end anastomosis (E-E-AN) than with a proximal end-to-side anastomosis (E-S-AN), 100% v 93%, respectively, after 1.5 years in a consecutive series of 38 E-S-ANs followed by 41 E-E-ANs. The two operations were equally effective in relieving hip claudication, but impotence occurred more frequently after E-E-AN (27%) than after E-S-AN (13%). This difference was not significant, but six of ten patients with E-E-AN who became impotent had arteriographic patterns predicting that graft flow into hypogastric arteries might be compromised. Intraoperative studies demonstrated that acute bilateral occlusion of hypogastric arteries significantly decreases penile BP, but branches of the external iliac arteries also contribute to penile flow and may become the major route of supply in patients with hypogastric occlusive disease.
在连续进行的38例近端端侧吻合（E-S-AN）和41例近端端端吻合（E-E-AN）的主动脉双股动脉搭桥术中，1.5年后，近端端端吻合术后的移植肢体累积通畅率显著高于近端端侧吻合术，分别为100%和93%。两种手术在缓解臀部间歇性跛行方面同样有效，但E-E-AN术后阳痿的发生率（27%）高于E-S-AN术后（13%）。这种差异不显著，但10例E-E-AN术后出现阳痿的患者中有6例的动脉造影模式显示移植血管流入髂内动脉的血流可能受到影响。术中研究表明，双侧髂内动脉急性闭塞会显著降低阴茎血压，但髂外动脉分支也有助于阴茎血流，并且在髂内动脉闭塞性疾病患者中可能成为主要供血途径。
