Zempo N, Esato K, O-Hara M, Fujioka K, Kuga T, Takenaka H
First Department of Surgery, Yamaguchi University School of Medicine, Japan.
Int Surg. 1993 Apr-Jun;78(2):162-5.
The usefulness of polytetrafluoroethylene graft (PTFE) for primary below-knee femoropopliteal bypass was examined. Forty-five primary femoropopliteal bypasses with PTFE were performed in 35 patients during a 7-year period. Patients were divided into two groups: above-knee (A-K group, n = 20) and below-knee (B-K group, n = 25) bypass. Differences in intergroup patient demographics were not significant. The primary patency rate in the A-K group at 3 and 5 years was 83.6% and 50.2%, respectively, and was 76.2% at both 3 and 5 years in the B-K group. These differences were not significant. Cause of graft failure, 3 grafts in the A-K group and 5 grafts in the B-K group, was kinking or thrombus formation associated with intimal hyperplasia at the distal anastomosis. All grafts in the A-K group with more than 10% stenosis in the early postoperative period had more than 50% stenosis in the late postoperative period. On the other hand, the one graft in the B-K group with 25% stenosis in the early postoperative period had 50% stenosis in the late postoperative period. We concluded that the use of PTFE for primary below-knee femoropopliteal artery is reasonable when atherosclerosis in the proximal popliteal artery is slight. However, close follow-up is necessary to detect and treat graft stenosis early.
研究了聚四氟乙烯移植物（PTFE）用于原发性膝下股腘动脉搭桥术的有效性。在7年期间，对35例患者进行了45例采用PTFE的原发性股腘动脉搭桥术。患者分为两组：膝上（A-K组，n = 20）和膝下（B-K组，n = 25）搭桥术。两组患者的人口统计学差异不显著。A-K组3年和5年的原发性通畅率分别为83.6%和50.2%，B-K组3年和5年的原发性通畅率均为76.2%。这些差异不显著。移植物失败的原因，A-K组有3例，B-K组有5例，是与远端吻合口内膜增生相关的扭结或血栓形成。A-K组所有术后早期狭窄超过10%的移植物在术后晚期狭窄超过50%。另一方面，B-K组1例术后早期狭窄25%的移植物在术后晚期狭窄达50%。我们得出结论，当腘动脉近端动脉粥样硬化较轻时，使用PTFE进行原发性膝下股腘动脉搭桥术是合理的。然而，有必要密切随访以便早期发现和治疗移植物狭窄。
