56例胭动脉以下肢体动脉缺血的血管重建术分析

Clinical analysis of vascular reconstruction in 56 cases of lower extremity ischemia suffering from infrapopliteal arterial occlusion

目的总结胭动脉水平动脉闭塞血运重建术治疗的临床疗效。方法对2001年7月至2005年8月56例累及胭动脉及胭动脉以下三分支病变重建肢体血运进行回顾性分析。根据病变阻塞平面不同,采用不同的血管架桥,对多平面、多节段动脉闭塞采用聚四氟乙烯人工血管和自体静脉桥复合序贯架桥血运重建。结果术后平均随访17个月,移植血管一期通畅率67.3%,二期通畅率78.8%。结论复合序贯搭桥术治疗累及股浅-腘动脉水平以下多节段(平面)动脉闭塞症是一种较实用的方法,可有效解决自体血管不足和单纯使用人工血管胭动脉以下血管重建通畅率差的问题。

Objective To summarize therapeutic efficacy of vascular reconstruction in treating infrapopliteal arterial occlusion. Methods Retrospective analysis of vascular reconstruction of lower extremity was made in 56 cases suffering from popliteal arteries or 3 branches of popliteal arteries （ anterior tibial, posterior tibial, peroneal artery） between July 2001 and August 2005 in our hospital. According to the level of lower extremity arterial occlusion, a composite grafts which consisting of a combined proximal FIFE prosthesis grafts with autogenous vein grafts were used to establish the sequential vascular reconstruction for multilevel and multistage arterial occlusive disease. Results The mean follow-up period after operation was 17 months. The primary graft patency rates in this series was 67. 3%, the secondary graft patency rate was 78.8%. Condusions The treatment of composite sequential bypass is a practical means for multilevel arterial occlusive disease suffering from femoral-infrapopliteal arteries, which effectively resolves the insufficiency supply of autogenous vessel grafts and the problem of bad patency rate for vascular reconstruction with prosthetic grafts alone in arterial occlusion suffering from infrapopliteal arteries.