Aune S, Pedersen O M, Trippestad A
Department of Surgery, Haukeland University Hospital, Bergen, Norway.
Eur J Vasc Endovasc Surg. 1998 Dec;16(6):509-12. doi: 10.1016/s1078-5884(98)80242-6.
To evaluate a surveillance programme based on colour duplex ultrasound scanning of above-knee prosthetic femoropopliteal bypass.
A retrospective clinical study.
One hundred and eighteen above-knee prosthetic femoropopliteal bypass procedures performed from 1993 to 1996.
Scans were done at 1, 3, 6 and 12 months, and annually thereafter. Significant graft-related stenotic lesions were defined as 50% diameter reduction or more located at the inflow or outflow arteries, or associated with the graft. Identified lesions were treated by angioplasty or surgical repair.
The primary and secondary patency rates at 2 years were 55% and 71%, respectively. Stenotic lesions were documented on 45 of 463 scans (9.7%). Twenty-nine grafts (25%) were treated and only six of these grafts (21%) occluded. This was significantly superior to the occlusion rate of 41% for the whole series.
It appears that one-quarter of above-knee prosthetic femoropopliteal bypasses develop graft-related stenoses. The favourable prognosis of these grafts after treatment for stenotic lesions justifies a surveillance programme. However, most graft occlusions seem to occur in grafts where no stenotic lesion has been previously detected.
评估一项基于彩色双功超声扫描的膝上人工血管股腘动脉旁路移植术监测方案。
一项回顾性临床研究。
1993年至1996年期间进行的118例膝上人工血管股腘动脉旁路移植手术。
在术后1、3、6和12个月进行扫描，之后每年进行一次。与移植物相关的显著狭窄病变定义为流入或流出动脉处直径缩小50%或更多，或与移植物相关。确定的病变通过血管成形术或手术修复进行治疗。
2年时的一期和二期通畅率分别为55%和71%。在463次扫描中的45次（9.7%）记录到狭窄病变。29条移植物（25%）接受了治疗，其中只有6条移植物（21%）闭塞。这明显优于整个系列41%的闭塞率。
似乎四分之一的膝上人工血管股腘动脉旁路移植术会出现与移植物相关的狭窄。这些移植物在治疗狭窄病变后的良好预后证明了监测方案的合理性。然而，大多数移植物闭塞似乎发生在之前未检测到狭窄病变的移植物中。
