腋-腋动脉人工血管转流术在血管外科疾病53例中的应用

Axillo-axillary bypass grafting for the treatment of contralateral arterial ischemia of upper limb

目的探讨腋 腋动脉人工血管转流术在血管外科疾病中应用的价值。方法回顾性分析、总结 8年间行腋 腋动脉人工血管转流术的 5 3例患者的临床资料 ,其中单侧锁骨下动脉闭塞 46例 ;锁骨下动脉瘤 3例 ;锁骨下动脉创伤 4例。仅有肢体缺血症状的 33例 ;同时伴有锁骨下动脉窃血症状的 18例。 2例真性动脉瘤患者无缺血和窃血症状。结果 5 3例患者术后上肢缺血及锁骨下动脉窃血症状消失 ,动脉瘤得以根治 ,患肢动脉搏动恢复正常 ,双侧肱动脉压力差均小于或等于10mmHg。无任何手术并发症发生。治愈率为 10 0 %。 39例得到术后随访 ,随访率为 74% ,平均随访时间 3年 3个月。所有转流人工血管均通畅良好。结论腋 腋动脉人工血管转流术是一种方法简单易行、创伤小、风险低、并发症少、手术时间短、术后恢复快的术式 ,特别适合于有严重心脑血管疾病、年老、体弱或锁骨下动脉起始部难以显露。

ObjectiveTo evaluate the efficacy of axillo-axillary bypass grafting for the treatment of contralateral arterial ischemia of upper limb. Method 53 cases underwent axillo-axillary artery PTFE graft bypass among those there were 46 cases of subclavian artery occlusion and 3 cases of subclavian artery aneurysm and 4 cases of trauma. Preoperatively 33 cases suffered from a symptom of extremity ischemia and 18 cases with subclavian artery blood steal. Result Good results were achieved in all cases without any complications. Doppler test showed the gradient of bilateral brachial pressure artery was less 10 mmHg in all cases. ConclusionAxillo-axillary artery PTFE graft bypass is an effective method for subclavian artery reconstruction with less trauma and complications. It is especially suitable for the elders with concomitant heart brain and lung diseases. It is also applicable for cases in which the subclavian arteries are not easily accessible due to artery aneurysm and artery trauma.