Tersíp K, Jirásek A, Krivánek J, Smrcek L
I. Chirurgická Klinika, 1. Lékarská Fakulta, Univerzity Karlovy, Praha, Czech Republic.
Sb Lek. 1993;94(3):273-9.
The authors present a report dealing with their experience with reoperations for occlusion of vascular prostheses implanted in aorto-femoral region in the late postoperative period. The most frequent cause of this occlusions was the obstruction of the outflow track at the distal anastomosis. In small arteries (under 5 mm) this obstruction was mainly caused by myointimal proliferation which originated from the host artery. In the early period after occlusion it is possible to remove the thrombus from the prostheses mostly in all patients by means of Fogarty catheter and to ensure the long lasting passage of the prostheses by plastic operations of the origin of profunda femoral artery. In long lasting occlusions of the prostheses can thrombolytic therapy 1-2 weeks before reoperation facilitate removing of the thrombus. In 113 patients with the different type of reoperations for occlusion of the prostheses in the aorto-femoral region we succeeded in 102 patients (90.3%). In 8 patients the reoperation was not successful (7%) and we had to amputate the distal extremity and three patients (2.3%) died from the heart complications in the early postoperative period.
作者们发表了一份报告,阐述了他们对术后晚期主动脉-股动脉区域植入的血管假体闭塞进行再次手术的经验。这种闭塞最常见的原因是远端吻合口处流出道阻塞。在小动脉(直径小于5毫米)中,这种阻塞主要由源自宿主动脉的肌内膜增生引起。在闭塞后的早期,大多数患者可通过Fogarty导管从假体中清除血栓,并通过对股深动脉起始处进行整形手术确保假体的长期通畅。对于假体的长期闭塞,术前1-2周进行溶栓治疗有助于清除血栓。在113例因主动脉-股动脉区域假体闭塞而进行不同类型再次手术的患者中,102例手术成功(90.3%)。8例再次手术未成功(7%),我们不得不截肢远端肢体,3例患者(2.3%)在术后早期死于心脏并发症。