Polytetrafluoroethylene Femorotibial Bypass Grafting: 5-year Patency and Limb Salvage
Polytetrafluoroethylene Femorotibial Bypass Grafting: 5-year Patency and Limb Salvage
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聚四氟乙烯股胫旁路移植术：5 年通畅和保肢
DOI：
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发表时间：
2003
影响因子：
1.5
通讯作者：
P. Breslau
中科院分区：
文献类型：
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作者：
P. Klinkert;P. J. E. Dijk;P. Breslau
对于股-胫骨搭桥术，选择的材料是自体静脉。问题仍然是，如果没有自体静脉，假体材料是否是保肢的合理选择。从1991年到1998年，我们对70例患者进行了83例股骨-胫骨旁路手术。由于没有自体静脉，使用的是薄壁、环状6 mm聚四氟乙烯(PTFE)。所有病例的股胫骨搭桥术指征均为动脉粥样硬化性闭塞症所致的严重缺血。3例患者在医院内或手术后30天内死亡，围术期死亡率为3.6%。5年后死亡33例(40%)，失访3例(3.6%)。术后6周通畅率为64.2%，5年通畅率为18%±5%。术后6周再通率为74.1%，5年再通率为22.3%±6%。当我们比较远端吻合口的一期和二期通畅率时，三条脚动脉之间没有差异。术后5年肢体保留率为61.9%±7%。根据这些结果，我们得出结论，如果没有自体静脉可用，PTFE对于严重缺血患者的股胫骨搭桥是一种可接受的替代方案，肢体保留率为61.9%。
For a femorotibial bypass graft the material of choice is autologous vein. The question remains whether prosthetic material is a reasonable alternative for limb salvage, if autologous vein is not available. From 1991 to 1998, 83 consecutive femorotibial bypass procedures were performed in 70 patients. Thin-walled, ringed 6-mm polytetrafluoroethylene (PTFE) was used, as autologous vein was not available. The indication for the femorotibial bypass was critical ischemia due to atherosclerotic occlusive disease in all cases. Three patients died in the hospital or within 30 days of the operation, resulting in a perioperative mortality rate of 3.6%. After 5 years, 33 patients had died (40%) and 3 patients were lost to follow-up (3.6%). Primary patency was 64.2% after 6 weeks and 18% ± 5% after 5 years. Secondary patency was 74.1% after 6 weeks and 22.3% ± 6% after 5 years. When we compared primary and secondary patency for distal anastomosis, there was no difference between the three crural arteries. The limb salvage rate was 61.9% ± 7% after 5 years. From these results we conclude that, with a limb salvage of 61.9%, PTFE is an acceptable alternative for a femorotibial bypass graft in patients with critical ischemia, if autologous vein is not available.
影响因子：
4.3
作者：
Parsons, RE;Suggs, WD;Schwartz, ML
通讯作者：
Schwartz, ML