Yasuhara H, Shigematsu H, Kobayashi I, Muto T
First Department of Surgery, University of Tokyo, Japan.
Surg Today. 1995;25(10):897-900. doi: 10.1007/BF00311755.
The influences of atherogenic response on restenosis after transluminal balloon angioplasty and the anastomosis of arterial reconstruction were investigated. Iliac transluminal balloon angioplasty was performed on 81 consecutive patients at 86 sites, between January, 1987 and December, 1992. A balloon angioplasty alone was performed in 58 patients at 60 sites, while distal revascularization was performed in 23 patients on 26 limbs, in association with the angioplasty. An improvement in the inflow of the distal grafts was achieved in 22 of these 23 patients in 26 limbs. The combined distal revascularization included 21 femoropopliteal bypasses, 3 femorofemoral bypasses, and 2 thromboendarterectomies at the profunda femoris arteries. A reduction in the luminal diameter after the balloon angioplasty was determined by means of follow-up arteriograms which showed no obvious progression of the restenosis at the angioplasty sites even when neointimal hyperplasia had developed at the anastomosis of the arterial reconstruction. The accumulative graft patency rate of the combined distal revascularization did not differ significantly from that of femoropopliteal reconstructions alone during the same study period. This study demonstrated that concomitant surgical insults do not have a detrimental effect on restenoses at angioplasty sites.
研究了动脉粥样硬化反应对经皮腔内球囊血管成形术后再狭窄及动脉重建吻合口的影响。1987年1月至1992年12月期间，对81例连续患者的86个部位进行了髂动脉经皮腔内球囊血管成形术。58例患者的60个部位仅进行了球囊血管成形术，而23例患者的26条肢体在进行血管成形术的同时进行了远端血管重建。这23例患者的26条肢体中有22条实现了远端移植物血流改善。联合远端血管重建包括21例股腘动脉旁路移植术、3例股股动脉旁路移植术和2例股深动脉血栓内膜切除术。通过随访动脉造影确定球囊血管成形术后管腔直径的减小，结果显示即使在动脉重建吻合口出现内膜增生时，血管成形术部位的再狭窄也无明显进展。在同一研究期间，联合远端血管重建的累积移植物通畅率与单纯股腘动脉重建的累积移植物通畅率无显著差异。本研究表明，同时进行的手术损伤对血管成形术部位的再狭窄没有不利影响。
