腹主动脉瘤和下肢闭塞性动脉疾病。
Abdominal aortic aneurysm and lower-limb occlusive arterial disease.
作者信息
Hassen-Khodja R, Le Bas P, Pittaluga P, Batt M, Declemy S, Bariseel H
机构信息
Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Saint-Roch, France.
出版信息
J Cardiovasc Surg (Torino). 1998 Apr;39(2):141-5.
BACKGROUND
Abdominal aortic aneurysms (AAA) are associated with lower-limb occlusive arterial disease (LLOAD) in 20-40% of patients. Retrospective analysis of 200 elective AAA repairs and comparison with literature data revealed that LLOAD has little influence on standard therapeutic management of AAA.
METHODS
In this study, only 2.5% of the patients required femoropopliteal bypass along with aneurysm repair. In contrast, aneurysm repair was associated with lumbar sympathectomy in 30% of cases owing to existence of peripheral arterial disease.
RESULTS
Concurrent LLOAD did not significantly increase the operative mortality of AAA, but postoperative peripheral arterial complications were more frequent in patients with both aneurysmal and occlusive disease.
CONCLUSIONS
Although concomitant LLOAD did not adversely affect the long-term survival of patients who underwent surgical repair of AAA, this subgroup of patients was at higher risk of aggravation of their lower extremity arterial lesions.
背景
20% - 40%的腹主动脉瘤（AAA）患者合并下肢闭塞性动脉疾病（LLOAD）。对200例择期AAA修复手术进行回顾性分析，并与文献数据比较，发现LLOAD对AAA的标准治疗管理影响不大。
方法
在本研究中，仅2.5%的患者在进行动脉瘤修复时需要股腘动脉旁路移植术。相反，由于存在外周动脉疾病，30%的病例在动脉瘤修复时同时进行了腰交感神经切除术。
结果
合并LLOAD并未显著增加AAA的手术死亡率，但动脉瘤和闭塞性疾病并存的患者术后外周动脉并发症更为常见。
结论
虽然合并LLOAD并未对接受AAA手术修复患者的长期生存产生不利影响，但该亚组患者下肢动脉病变加重的风险更高。
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