采用肱静脉、小隐静脉及大隐静脉残端进行股腘动脉重建：257例报告
Infrainguinal reconstruction with arm vein, lesser saphenous vein, and remnants of greater saphenous vein: a report of 257 cases.
作者信息
Londrey G L, Bosher L P, Brown P W, Stoneburner F D, Pancoast J W, Davis R K
机构信息
Virginia Surgical Associates, P.C., Richmond 23226.
出版信息
J Vasc Surg. 1994 Sep;20(3):451-6; discussion 456-7. doi: 10.1016/0741-5214(94)90145-7.
PURPOSE
The purpose of this study was to evaluate the results of infrainguinal reconstructions with arm vein, lesser saphenous vein, and remnants of greater saphenous vein (ectopic vein grafts).
METHODS
The records of 222 patients who underwent 257 bypasses were restrospectively reviewed. Most of the grafts were placed for rest pain or tissue loss (88%) and were secondary reconstructions (70%) to the infrapopliteal level (90%). Single-length vein grafts were constructed in 66% of cases, whereas 34% were composite vein grafts.
RESULTS
Secondary graft patency was 70%, 52%, and 43% at 1, 3, and 5 years. Single-length grafts had significantly better patency rates at all intervals: 78% versus 56% at 1 year (p = 0.001), 60% versus 39% at 3 years (p = 0.004), and 52% versus 29% at 5 years (p = 0.002). The limb salvage rate was 69% at 5 years.
CONCLUSIONS
Ectopic vein grafts with primarily arm vein are an acceptable alternative for infrainguinal reconstruction in the absence of suitable ipsilateral greater saphenous vein.
目的
本研究的目的是评估采用肱静脉、小隐静脉和大隐静脉残端（异位静脉移植物）进行膝下血管重建的结果。
方法
回顾性分析了222例行257次旁路手术患者的记录。大多数移植物用于治疗静息痛或组织缺损（88%），且为膝下水平（90%）的二次重建（70%）。66%的病例采用单段静脉移植物，34%为复合静脉移植物。
结果
二次移植物通畅率在1年、3年和5年时分别为70%、52%和43%。单段移植物在所有时间间隔的通畅率均显著更高：1年时为78%对56%（p = 0.001），3年时为60%对39%（p = 0.004），5年时为52%对29%（p = 0.002）。5年时肢体挽救率为69%。
结论
在没有合适的同侧大隐静脉时，主要采用肱静脉的异位静脉移植物是膝下血管重建的一种可接受的替代方法。
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