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【J Vasc Surg】自体股浅动脉移植应用于膕动脉瘤切
Superficial femoral artery autograft reconstruction in the treatment of popliteal artery aneurysm: Long-term outcome
Nikolaos Paraskevas, Yves Castier, Patrick Soury, Gabriel Thabut, Guy Leseche, Claude Laurian,
Objective
This prospective, observational study evaluated the safety and efficacy of superficial femoral artery autograft reconstruction in the treatment of popliteal artery aneurysms in the absence of a suitable saphenous vein.
Methods
From March 1997 to April 2007, data from patients with popliteal artery aneurysms treated by superficial femoral artery reconstruction were prospectively collected in two centers. The procedure was performed through a medial approach. The superficial femoral artery was harvested in the upper third of the thigh and used as the conduit for reconstruction, and the harvested segment was replaced by a polytetrafluoroethylene graft. The patients were observed for survival, limb salvage, and reconstruction patency. The results were calculated by the Kaplan-Meier method.
Results
During the 10-year study period, 37 popliteal artery aneurysms in 32 patients (all men; median age, 71 years) were treated by reconstruction using the superficial femoral artery. Indications for surgical treatment were symptomatic or complicated aneurysms in 11 (30%). Four (11%) of the 37 popliteal artery aneurysms were thrombosed, and 33 (89%) were patent. At surgery, 35% had a single vessel runoff. Because of acute ischemia, reconstruction was performed as an emergency procedure in three patients (8%). There were no perioperative deaths, early amputations, or early thrombosis. The mean follow-up period was 36 months (range, 7-103 months). Two grafts thrombosed during follow-up. At 3 years, the primary and secondary patency rates were 86% and 96%, and overall limb salvage was 100%. Follow-up duplex ultrasonography did not detect any aneurysmal dilatation of the autograft.
Conclusion
Our experience shows that superficial femoral arterial reconstruction is a safe and useful treatment option in patients with popliteal artery aneurysms who lack suitable saphenous veins. This reconstruction seems to be a good alternative to prosthetic bypass crossing the knee joint, and our results suggest that this study should be continued. http://www.jvascsurg.org/article/S0741-5214(08)00508-9/abstract
Superficial femoral artery autograft reconstruction in the treatment of popliteal artery aneurysm: Long-term outcome
以股浅动脉为自体移植物重建治疗腘动脉瘤的长期结果
Nikolaos Paraskevas, Yves Castier, Patrick Soury, Gabriel Thabut, Guy Leseche, Claude Laurian,
Objective
This prospective, observational study evaluated the safety and efficacy of superficial femoral artery autograft reconstruction in the treatment of popliteal artery aneurysms in the absence of a suitable saphenous vein.
目的
该前瞻性观测性研究评估了在缺乏合适的隐静脉的情况下以股浅动脉为自体移植物重建治疗腘动脉瘤的安全性和有效性。
Methods
From March 1997 to April 2007, data from patients with popliteal artery aneurysms treated by superficial femoral artery reconstruction were prospectively collected in two centers. The procedure was performed through a medial approach. The superficial femoral artery was harvested in the upper third of the thigh and used as the conduit for reconstruction, and the harvested segment was replaced by a polytetrafluoroethylene graft. The patients were observed for survival, limb salvage, and reconstruction patency. The results were calculated by the Kaplan-Meier method.
方法
自1997年3月至2007年4月，股浅动脉重建治疗治疗腘动脉瘤的患者资料在两个中心进行了前瞻性的收集。手术取内侧入路。股浅动脉取自大腿的上1/3段并用于腘动脉重建，股浅动脉切除段以聚四氟乙烯人工血管替代。观察病人的生存率，救肢率，和重建后血管的通畅性。结果统计采用Kaplan-Meier法。
Results
During the 10-year study period, 37 popliteal artery aneurysms in 32 patients (all men; median age, 71 years) were treated by reconstruction using the superficial femoral artery. Indications for surgical treatment were symptomatic or complicated aneurysms in 11 (30%). Four (11%) of the 37 popliteal artery aneurysms were thrombosed, and 33 (89%) were patent. At surgery, 35% had a single vessel runoff. Because of acute ischemia, reconstruction was performed as an emergency procedure in three patients (8%). There were no perioperative deaths, early amputations, or early thrombosis. The mean follow-up period was 36 months (range, 7-103 months). Two grafts thrombosed during follow-up. At 3 years, the primary and secondary patency rates were 86% and 96%, and overall limb salvage was 100%. Follow-up duplex ultrasonography did not detect any aneurysmal dilatation of the autograft.
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作者:admin@医学,生命科学 2011-03-28 05:14
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