Comparison of superficial femoral vein and saphenous vein as conduits for mesenteric arterial bypass.
Comparison of superficial femoral vein and saphenous vein as conduits for mesenteric arterial bypass.
复制标题
股浅静脉和隐静脉作为肠系膜动脉旁路导管的比较。
DOI：
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发表时间：
2003
影响因子：
4.3
通讯作者：
G. Clagett
中科院分区：
文献类型：
--
作者：
J. Modrall;Javid Sadjadi;Donald R. Joiner;Ahsan T. Ali;M. Welborn;M. Jackson;R. Valentine;G. Clagett
目的
肠坏疽、腹腔内脓毒症和既往肠系膜旁路手术失败是使用自体管道进行肠系膜动脉重建的适应症。大隐静脉常被用作自体血管的首选，但它可能容易发生移植物狭窄或闭塞。最近的经验表明，股浅静脉（SFV）是一个很好的替代管道主要动脉重建。本研究的目的是比较SV和SFV用于肠系膜动脉旁路的结果。
方法
在7年的时间里，26例患者接受了43次自体管道肠系膜动脉旁路手术。SV用于23例旁路（53%），SFV用于20例旁路（47%）。血运重建的适应症包括慢性肠系膜缺血（n = 15; 58%）、急性肠系膜缺血（n = 9; 35%）和巩膜旁主动脉的肌层动脉瘤（n = 2; 7%）。3例患者（11%）在既往肠系膜旁路移植术失败后接受了SV移植物血运重建，2例患者（8%）接受了SFV移植物血运重建。
结果
30天死亡率为15%。3例死亡发生在SV旁路术治疗急性肠系膜缺血后，1例死亡发生在SFV旁路术治疗破裂的巩膜旁肌层动脉瘤后。对22例存活患者进行了平均31 +/-6个月的随访。SV旁路术后存活的11例患者中有3例（27%）在术后平均32 +/-22个月时发生了移植物血栓形成导致的复发性肠系膜缺血（急性，n = 1;慢性，n = 2）。无一例术后症状复发。3例SV移植失败的患者中有1例死于急性肠系膜缺血，另外2例患者成功接受了SFV转流。与SFV移植相比，SV移植的患者更容易发生症状性移植失败（P <0.05）。
结论
与SV相比，SFV产生了可接受的肠系膜动脉搭桥临床结局。当自体管道适用于肠系膜动脉重建时，SFV是SV的可行替代方案。
PURPOSE
Gangrenous bowel, intraabdominal sepsis, and previous failed mesenteric bypass are indications for use of an autogenous conduit for mesenteric arterial reconstruction. Saphenous vein (SV) is often used as the autogenous conduit of choice, but it may be prone to graft stenosis or occlusion. Recent experience with superficial femoral vein (SFV) suggests that it is an excellent alternative conduit for major arterial reconstruction. The purpose of this study was to compare the outcomes of SV and SFV for mesenteric arterial bypass.
METHODS
During a 7-year period, 26 patients underwent 43 mesenteric arterial bypass procedures with autogenous conduit. SV was used for 23 bypasses (53%), and SFV was used for 20 bypasses (47%). Indications for revascularization included chronic mesenteric ischemia (n = 15; 58%), acute mesenteric ischemia (n = 9; 35%), and mycotic aneurysm of the paravisceral aorta (n = 2; 7%). Three patients (11%) underwent revascularization with SV grafts and two patients (8%) with SFV grafts after previous failed mesenteric bypass.
RESULTS
The 30-day mortality rate was 15%. Three deaths occurred after SV bypass for acute mesenteric ischemia, and one death occurred after a SFV bypass for a ruptured paravisceral mycotic aneurysm. Twenty-two surviving patients were followed for a mean of 31 +/- 6 months. Three of 11 patients (27%) who survived after SV bypass had recurrent mesenteric ischemia develop (acute, n = 1; chronic, n = 2) from graft thrombosis at a mean interval of 32 +/- 22 months after surgery. No patient had recurrent symptoms develop after SFV bypass. One of the three patients with SV graft failure died of acute mesenteric ischemia, and the other two patients underwent successful bypass with SFV. Symptomatic graft failure was significantly more likely to occur in patients receiving SV grafts compared with SFV grafts (P <.05).
CONCLUSION
SFV yields acceptable clinical outcomes for mesenteric arterial bypass compared with SV. SFV is a viable alternative to SV when autogenous conduit is indicated for mesenteric arterial reconstruction.
股浅静脉腘静脉：解剖学研究。
影响因子：
4.3
作者：
Santilli,SM;Lee,ES;Wernsing,SE;Diedrich,DA;Kuskowski,MA;Shew,RL
通讯作者：
Shew,RL