Lovricević I, Despot I, DeSyo D, Vukelić M, Hudorović N
Klinicka bolnica Sestre milosrdnice, Odsjek za vaskularnu kirurgiju, Zagreb.
Lijec Vjesn. 1997 Jan;119(1):22-6.
Femoropopliteal and femorocrural bypass, managed by "in situ" procedure with the use of angioscope, became a standard surgical method in the treatment of occlusive process in the arteries of lower extremities in the Department of Vascular Surgery, Clinical Hospital "Sestre milosrdnice" in Zagreb. The capabilities of angioscopy in diagnosis and in surgery are presented, with special emphasis on bypass "in situ" procedure. Technical difficulties encountered in bypass formation and our solutions are described. From December 1993 to December 1994, eleven patients were operated. Common femoral artery was used for proximal anastomosis in four patients. Superficial femoral artery was used in five patients, and profound femoral artery was used in two patients. The third segment of popliteal artery was used for distal anastomosis in five cases. In six cases crural bypass was done. Three of them were on posterior tibial artery, two were on fibular artery and one was on anterior tibial artery. Two out of four or 50% of femoropopliteal bypasses are patent after the first year. One patient died of cardiorespiratory complications in the early postoperative period. Femorocrural bypasses are patent in five out of six patients or 83.3%. Bypass with great saphenous vein "in situ" is the procedure of choice, especially in femorocrural position.
在萨格勒布“慈善姐妹会”临床医院血管外科，使用血管镜通过“原位”手术进行的股腘和股小腿旁路移植术，已成为治疗下肢动脉闭塞性病变的标准手术方法。本文介绍了血管镜在诊断和手术中的应用能力，特别强调了“原位”旁路移植术。描述了旁路形成过程中遇到的技术难题及我们的解决方法。1993年12月至1994年12月，对11例患者进行了手术。4例患者采用股总动脉进行近端吻合。5例患者采用股浅动脉，2例患者采用股深动脉。5例患者采用腘动脉第三段进行远端吻合。6例患者进行了小腿旁路移植术。其中3例是在胫后动脉，2例是在腓动脉，1例是在前胫动脉。4例股腘旁路移植术中，有2例（50%）在术后第一年通畅。1例患者在术后早期死于心肺并发症。6例股小腿旁路移植术中，有5例（83.3%）通畅。大隐静脉“原位”旁路移植术是首选方法，尤其在股小腿部位。
