Bertoglio C, Fornaro R, Carissimi T, Prandi M, Boaretto R, Caiolo V F, Maritato F, Ferraris R
Cattedra di Semeiotica Chirurgica, Università degli Studi di Genova.
Chir Ital. 1995;47(4):33-40.
The Authors report the result of their ten-years experience with femoro-femoral crossover bypass in 26 patients affected with unilateral occlusion of the iliac artery. This bypass is an easy and quick procedure, useful in both short and long term. The patency rate after 58 months is 84.6%. Thus, its use indicated in a high number of patients, not only for a limb salvage treatment of a disabling claudication. The indications for this bypass can be extended to low surgical risk subjects, and it does not have to be considered only for the high-risk patients, instead of major surgery procedure on the aorto-iliac axis. The minimal necessary conditions of the limbs for performing the femoro-femoral crossover bypass are a pressure gradient of 35 mmHg and the angiographical demonstration of the unilateral occlusion. If the contralateral axis appears patent, but there are also multiple atherosclerotic sites, we consider other bypasses as therapeutical choices: aorto-bifemoral, ilio-femoral and the femoro-femoral cross-over itself; in the latter case we previously perform a transluminal angioplasty or an endarterectomy of the donor iliac artery. In these situations is essential to evaluate of the benefit/risk rate for every single patient.
作者报告了他们对26例单侧髂动脉闭塞患者进行股-股交叉旁路移植术的十年经验结果。这种旁路手术是一种简单快捷的手术，在短期和长期都很有用。58个月后的通畅率为84.6%。因此，它适用于大量患者，不仅用于肢体挽救治疗致残性跛行。这种旁路手术的适应证可以扩大到手术风险低的患者，而且不必仅考虑高危患者，而不是在主-髂动脉轴上进行大手术。进行股-股交叉旁路移植术所需的肢体最低必要条件是压力梯度为35mmHg以及单侧闭塞的血管造影显示。如果对侧血管轴看起来通畅，但也存在多个动脉粥样硬化部位，我们将其他旁路手术作为治疗选择：主-双股动脉旁路术、髂-股动脉旁路术和股-股交叉旁路术本身；在后一种情况下，我们之前会对供体髂动脉进行腔内血管成形术或动脉内膜切除术。在这些情况下，评估每个患者的获益/风险率至关重要。
