静脉动脉化治疗广泛性下肢动脉闭塞症

Venous Arterialization in the Treatment of Extensive Arterial Occlusion of the Lower Extremities

目的:探讨静脉动脉化手术对广泛性下肢动脉闭塞症的疗效.方法:对有慢性缺血表现的20条下肢行Doppler超声与DSA或MRA检查,确诊为广泛性下肢动脉闭塞症.然后用分期或一期静脉动脉化手术对所有患肢进行治疗.结果:术后近期3条截肢.17条患肢随访6～51个月,其中2条患肢深静脉血栓形成,15条患肢疗效理想,症状消失.术后Doppler超声与MRA复查可见动脉血向缺血肢体灌注.结论:静脉动脉化治疗广泛性下肢动脉闭塞症疗效良好,为治疗该病开辟了一条新途径.

Objective: To evaluate the therapeutic effects of venous arterialization on the extensive occlusion of lower extremities. Methods: 20 limbs affected chronic ischemia were diagnosed as extensive occlusion by Doppler ultrasound and DSA or MRA. Primary or staged venous arterialization operations were used for treatment. Results: Amputations were performed in 3 limbs soon after the operation. The follow-up of 17 limbs (6 months to 51 months) showed, deep venous thrombosis occurred in 2 limbs and 15 limbs had excellent results with disappearance of symptoms. After operation, Doppler ultrasound and MRA examination showed that arterial blood flowed to the ischemic limbs. Conclusions: Venous arterialization operation yielded satisfactory results in extensive occlusion of lower limbs. This operation create a new approach for the treatment of this disease.