Brewster D C, Perler B A, Robison J G, Darling R C
Arch Surg. 1982 Dec;117(12):1593-600. doi: 10.1001/archsurg.1982.01380360065010.
Results of aortofemoral reconstruction of 181 consecutive patients with multilevel occlusive disease were reviewed and correlated with possible predictors of outcome. Overall, 74% of patients attained satisfactory relief of ischemic symptoms with proximal operation alone. Forty-six patients (26%) had an unsatisfactory result, 31 (17%) of whom underwent distal bypass grafts. Of 42 variables studied, 12 achieved statistical significance as predictors of outcome, and multivariate analysis identified five factors an independent indicators. Factors documenting hemodynamically significant inflow disease were associated most strongly with a good result. Several noninvasive laboratory variables were found helpful, particularly in assessing the hemodynamic compensation of distal disease. While no single variable reliably indicated the definite need for distal grafting, careful consideration of important factors together with the clinical situation will aid the surgeon in selection of the small group of patients best treated by synchronous aortofemoral and femoropopliteal grafts.
回顾了181例连续性多级闭塞性疾病患者的主-股动脉重建结果，并将其与可能的预后预测因素进行关联分析。总体而言，仅行近端手术的患者中有74%获得了缺血症状的满意缓解。46例患者（26%）结果不满意，其中31例（17%）接受了远端旁路移植术。在研究的42个变量中，有12个作为预后预测因素具有统计学意义，多因素分析确定了5个因素为独立指标。记录血流动力学上显著的流入道疾病的因素与良好结果的相关性最强。发现几个非侵入性实验室变量有帮助，特别是在评估远端疾病的血流动力学代偿方面。虽然没有单一变量能可靠地表明绝对需要进行远端移植，但综合考虑重要因素并结合临床情况将有助于外科医生选择一小部分最适合同时进行主-股动脉和股-腘动脉移植治疗的患者。
