Intraoperative flow predicts the development of stenosis in infrainguinal vein grafts.
Intraoperative flow predicts the development of stenosis in infrainguinal vein grafts.
复制标题
术中流量可预测腹股沟下静脉移植物狭窄的发生情况。
DOI：
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复制
发表时间：
2001
影响因子：
4.3
通讯作者：
M. Lepäntalo
中科院分区：
文献类型：
--
作者：
L. Ihlberg;N. Albäck;R. Lassila;M. Lepäntalo
目的
有数据表明，肌内膜增生的发展受到血流长期变化的影响。然而，这些发现的临床相关性尚未得到证实。
方法
在这项回顾性临床研究中，使用通过时间流量计对241例患者的257条腹股沟下静脉移植物进行了术中体积流量测量。这些患者参加了一项基于强化双工扫描的监测计划。评价术中移植物血流与随后闭塞或狭窄发展之间的关系，并控制其他相关风险因素。
结果
中位随访时间为13.6个月。移植血管狭窄58例。无事件移植物的平均移植物流量为98 mL/min，显著高于狭窄移植物的78 mL/min或闭塞移植物的69 mL/min。根据移植物血流测量的样本分布的四分位数将患者分为四组。最低至最高移植物流量组的2年一期和辅助一期通畅率分别为39%、49%、47%和72%（P = 0.003）和55%、67%、71%和84%（P = 0.01）。类似的显着差异，观察到最大流量测量。在多元回归模型中，女性（P = 0.009）和最大流量测量中的低移植物流量（P = 0.003）是狭窄发展的独立预测因素。
结论
术中移植物体积流量是腹股沟下旁路术后旁路阻塞的预测因子。此外，本研究证实了临床明显的移植物狭窄和低移植物血流之间的相关性。
OBJECTIVE
There are data to suggest that the development of myointimal hyperplasia is affected by long-term alterations in blood flow. However, the clinical relevance of these findings has not been demonstrated.
METHODS
In this retrospective clinical study, intraoperative volume flow measurement with transit time flowmeter was performed in 257 infrainguinal vein grafts carried out in 241 patients. The patients were enrolled in an intensive duplex scanning-based surveillance program. The relationship between the intraoperative graft flow and subsequent occlusion or development of stenosis was evaluated and controlled for other pertinent risk factors.
RESULTS
The median follow-up time was 13.6 months. A graft stenosis was found in 58 grafts. The mean graft flow for event-free grafts was 98 mL/min, which was significantly higher compared with 78 mL/min for stenosed or 69 mL/min for occluded grafts. The patients were divided into four groups according to quartiles of the sample distribution of graft flow measurements. The respective 2-year primary and assisted primary patency rates in the lowest to the highest graft flow groups were 39%, 49%, 47%, and 72% (P =.003) and 55%, 67%, 71%, and 84% (P =.01). Analogous significant differences were observed for maximal flow capacity measurements. Female sex (P =.009) and low graft flow in maximal flow capacity measurements (P =.003) were independent predictors of stenosis development in the multiple regression model.
CONCLUSION
Intraoperative graft volume flow is a predictor of bypass occlusion after infrainguinal bypass. In addition, this study verifies an association between the development of clinically evident graft stenoses and low graft flow.
影响因子：
56.9
作者：
DIAMOND, SL;ESKIN, SG;MCINTIRE, LV
通讯作者：
MCINTIRE, LV
灵长类动物动脉平滑肌的生长是否受内皮一氧化氮合酶调节？
影响因子：
4.3
作者：
Mattsson,EJ;Geary,RL;Kraiss,LW;Vergel,S;Liao,JK;Corson,MA;Au,YP;Hanson,SR;Clowes,AW
通讯作者：
Clowes,AW