Dusmet M, Worreth M, Merlini M
Département de chirurgie, Hôpital, La Chaux-de-Fonds.
Helv Chir Acta. 1994 Jul;60(5):733-8.
Atherosclerosis predominantly affects the ilio-superficial femoral axis, and tends to spare the deep femoral artery which can offer excellent outflow for proximal reconstructions for occlusive vascular disease of the lower limbs. Often symptoms are relieved and ischemic lesions can heal. The deep femoral artery can also provide good, pulsatile inflow for distal reconstructions when it is desirable to avoid the groin (either because of multiple previous dissections or because of infection). Occasionally two-level sequential bypasses to and from the deep femoral artery are required for multilevel disease where the groin is to be avoided. Over the past 4 years we have performed 190 arterial reconstructions (41 central, 125 distal and 24 sequential two-level procedures). 19 times the proximal, distal or intermediate anastomosis was on the deep femoral artery. Short- and long-term results were good in these difficult patients, with relief of symptoms or significant improvement in most patients. Two major (and no minor) amputations were ultimately required. Arterial reconstructions using the deep femoral artery cannot only salvage many limbs, but offer good symptomatic relief in patients who are not suitable for usual reconstructive procedures.
动脉粥样硬化主要累及髂股浅动脉轴，而股深动脉往往不受影响，对于下肢闭塞性血管疾病的近端重建，股深动脉可提供良好的流出道。症状常可缓解，缺血性病变也可愈合。当需要避免腹股沟区（如既往多次手术或存在感染）时，股深动脉还可为远端重建提供良好的搏动性血流。对于需要避免腹股沟区的多节段病变，偶尔需要进行往返股深动脉的两级序贯搭桥术。在过去4年中，我们共进行了190例动脉重建手术（41例中心性、125例远端性和24例两级序贯手术）。有19次近端、远端或中间吻合口位于股深动脉上。这些病情复杂的患者短期和长期效果良好，大多数患者症状缓解或明显改善。最终仅需进行2例大截肢手术（无小截肢手术）。利用股深动脉进行动脉重建不仅可以挽救许多肢体，而且对于不适合常规重建手术的患者，还能有效缓解症状。
