腋-股架桥术治疗髂、股动脉闭塞性疾病

目的：总结腋—股架桥术治疗髂、股动脉闭塞或狭窄的疗效。方法：回顾性分析20例髂、股动脉闭塞或狭窄病例的临床资料、危险因素、手术指征及效果。结果：均行腋—股动脉架桥术，17例单侧，3例双侧，共26条；18例是为拯救肢体而手术，其1，3，5年通畅率为87％(20/23)，74％(17／23)及61％(14／23)。30d内死亡1例(占5％)。3例移植物在术后6．5个月内闭塞，均发生在股—股搭桥中，而腋—股搭桥则长期通畅。结论：对广泛的慢性髂、股动脉闭塞性疾病，腋—股架桥对于行主动脉重建有危险或预期寿命受限的病人不失为一种可行术式。

Axillofemoral Bypass for Iliofemoral Occlusive Disease

Objective To summarize the experience of axillofemoral bypass. Methods Consecutive axillofemoral bypass was performed in 20 cases of chronic iliofemoral occlusive disease. Patients' demography, risk factors, and the indications for surgery, outcomes were analyzed. Results In the 20 axillofemoral bypass grafts, 17 were unifemoral and 3 bifemoral.18 procedures were performed for limb salvage.Primary patency rates at 1,3, and 5 years were 87%(20/23),74%(17/23),and 61%(14/23). Thirty-days mortality rate was 5%.Occlusions occurred after the operation in three femorofemoral graft limbs while the patency of axillofemoral limbs were kept consistently. Conclusions For patients with chronic iliofemoral occlusive disease, axillofemoral bypass is an excellent operation in those possess the prohibitive risk for direct aortic reconstruction or those with limited life expectancy.