在内血管时代的极端绕道 (popliteal-to-distal bypass) 在内血管时代
Chiara Barillà1, Narayana Pipitò1, Domenico Squillaci1
1Vascular Surgery Unit, Department of Medical Sciences and Morpho-Functional Imaging - University of Messina, Messina, Italy.
Annals of vascular surgery
|April 8, 2024
概括
当有合适的静脉和动脉可用时,Popliteal-to-distal绕道手术为慢性四肢威胁性缺血 (CLTI) 提供了良好的结果. 这种手术在CLTI患者中显示出高通透性,四肢挽救和存活率.
科学领域:
- 血管外科 血管外科
- 心血管医学 心血管医学
- 手术结果研究研究.
背景情况:
- 慢性肢体威胁性缺血症 (CLTI) 具有显著的死亡率 (每年20%) 和截肢 (40%) 的风险,没有干预.
- 开放式旁路手术是CLTI的推治疗方法,取决于静脉质量,输出动脉通透度和外科手术技巧.
- 脊柱至远端绕道是本研究中评估的一种特定的外科手术方法.
研究的目的:
- 为了评估一级通透性,四肢救援,和生存率后的尾至远端绕道手术.
- 评估二次结果,包括无截肢生存率和二次通透性.
- 分析这种绕道技术在CLTI患者中的可行性和有效性.
主要方法:
- 从2016年1月到2021年12月,连续接受尾至远端绕道手术的患者的回顾性分析.
- 纳入标准侧重于接受这种特定绕道手术的CLTI患者.
- 初级终点包括初级通透性,四肢挽救和整体存活率;二级终点是无截肢存活率和二级通透性.
主要成果:
- 在包括的49名患者中,100%的人取得了技术上的成功.
- 两年的初级通透率为85%±5%,次级通透率为86%±3%.
- 两年整体存活率为81%±6%,无截肢存活率为70%±9%,肢体挽救率为81%±6%.
结论:
- 脊柱至远端绕道是一个技术要求很高的程序,需要显著的外科专业知识.
- 这项研究表明,当有足够的自身静脉和输出动脉可用时,这种绕道可以成功地进行,并且具有有利的通透率和存活率.
- 这种外科手术选择在精选的CLTI患者中有望挽救四肢.
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