下肢股腘动脉搭桥术中应用复合移植物6例报告

The Application of Composite Grafts in Femoro - popliteal Arterial Bypass

目的：为寻求一种有效的长距离膝下移植物来治疗下肢动脉长段阻塞或动脉旁路术后远端动脉阻塞。方法：自１９９５年２月～１９９９年２月采用复合移植物治疗下肢股腘动脉硬化闭塞症共６例，包括（１）“直接式”吻合法；（２）“跳跃式”吻合法；（３）“连贯式”吻合法：即先做膝上股腘动脉人造血管移植，再做人造血管－自体大隐静脉－膝下腘动脉端侧吻合。结果：经术后３年随访，６例中４例症状消失，２例症状同术前。结论：当无法应用单一的大隐静脉或人造血管时，复合移植物对治疗下肢股腘动脉长段闭塞，特别是病变累及膝下动脉时，是合适的血管代用品。

Objective: To search the graft of choice for treating long segment arterial occlusive lesions in lower extremity or occlusion of distal artery below the anastomosis postoperatively. Methods: Six patients with occlusive disease in the femoral- popliteal artery below knee were recieved arterial bypass with composite grafts from February 1995 to February 1999. The composite grafts consisted of prosthesis and autogenous saphenous vein. The operative methods included: 1. Prosthesis was directly anastomosed to the saphenous vein with end - end suture method. 2. 'Jump' anastomosis included prosthesis used in position above knee and saphenous vein below the knee separately, 3. The arterial bypass above knee was performed with prosthesis first and then the bypass from prosthesis to the popliteal artery below knee with saphenous vein using side - end suture method. Results: For three years follow - up, intermittent claudication disappeared in four of six patients. The ulcers of the feet were cured in all three patients. Conclusion: If suitable prosthesis or saphenous vein can not be available alone, the composite grafts may be the conduit of choice for the long segment arterial occlusive lesion involving below knee popliteal artery.