Woelfle K D, Bruijnen H, Zuegel N, Mayer H, Hudde M, Loeprecht H
Department of Vascular and Thoracic Surgery, Zentralklinikum, Augsburg, Germany.
Cardiovasc Surg. 1993 Dec;1(6):690-4.
An overview of a total of 135 in situ femorocrural bypass operations is given. In the operations all grafts were anastomosed distally to the infrapopliteal arteries: to the proximal half of the crural vessels 52 times and to the distal half 83 times. The indication for surgery was critical limb ischaemia. In addition to routine intraoperative angiography, orthograde angioscopy of the graft was carried out to assess the completeness of valvulotomy in 96 patients (group A). In 39 patients (group B) for whom an endoscope was not available, completion angiography was conducted to ensure graft integrity. The two groups were comparable with respect to their composition. On the basis of the endoscopic findings, revisions were performed in 17 patients with incomplete valve ablation in group A, whereas in group B there were no interventions (P < 0.01, chi 2 test). Using life-table analysis, cumulative primary patency rates for groups A and B were 76% and 76% at 30 days, 62% and 44% at 1 year and 43% and 27% at 4 years, respectively. By comparison with the log rank test, a significant difference in patency among both groups could not be established (P = 0.18).
本文概述了总共135例原位股腘动脉搭桥手术。在这些手术中，所有移植物均在腘下动脉远端进行吻合：吻合至小腿血管近端半段52次，吻合至远端半段83次。手术指征为严重肢体缺血。除了常规术中血管造影外，对96例患者（A组）进行了移植物顺行血管内镜检查，以评估瓣膜切开术的完整性。对于39例（B组）没有血管内镜的患者，进行了造影检查以确保移植物的完整性。两组在组成方面具有可比性。根据内镜检查结果，A组17例瓣膜消融不完全的患者进行了修复，而B组未进行干预（P<0.01，卡方检验）。使用寿命表分析，A组和B组的累积原发性通畅率在30天时分别为76%和76%，1年时分别为62%和44%，4年时分别为43%和27%。通过对数秩检验比较，两组之间的通畅率无显著差异（P=0.18）。
