在患有严重外周动脉疾病的患者中,可获得合适的单段大沙芬静脉
Moira A McGevna1, Molly Ratner2, Giancarlo Speranza2
1Rutgers Robert Wood Johnson Medical School, Piscataway, NJ.
Annals of vascular surgery
|July 24, 2025
概括
大多数患有慢性肢体威胁性缺血症 (CLTI) 的患者缺乏足够的大静脉 (GSV) 进行外科绕道. 适当的GSV的低患病率表明,内血管干预在CLTI治疗中仍然是常见的.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 血管成像 血管成像
背景情况:
- 在BEST-CLI试验中,在具有足够大静脉 (GSV) (≥3.0毫米) 的慢性四肢威胁性缺血症 (CLTI) 患者中,外科绕道比内血管干预的结果优越.
- 适当的GSV的患病率对于选择最佳的CLTI治疗策略至关重要.
- 在CLTI患者中,足够的GSV的可用性仍然在很大程度上是未知的.
研究的目的:
- 为了确定在被诊断为CLTI的患者中足够的GSV的流行率.
- 通过评估GSV适合外科绕道,为CLTI的治疗计划提供信息.
主要方法:
- 对70名CLTI患者 (关节腕指数≤0.60,有症状) 进行双边GSV声波测绘的回顾性分析.
- 测量GSV直径从骨结到远端小腿.
- 足够的GSV需要从骨结到中的最小直径为3.0毫米.
主要成果:
- 只有11.4%的CLTI患者具有充足的ipsilateralGSV;当包括逆侧GSV时,这一数字增加到14.3%.
- 在远端,GSV直径的充分性显著下降:在软骨关节的80%;在近端小腿的21%;在远端小腿的9%.
- 患有不充分的ipsilateral GSVs的患者不太可能患有充足的逆侧GSV (4.8%对50.0%).
结论:
- 大多数CLTI患者缺乏适合的ipsilateral或contralateralGSV用于低管旁路手术.
- 适当的GSV的低患病率,特别是在小牛,限制了外科绕道的选择.
- 血管内干预很可能仍然是常见的CLTI治疗方法,因为对绕道进行适当的GSVs的可用性有限.
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