下肢动脉硬化闭塞症腔内治疗失败后行旁路手术血运重建的临床疗效分析OACSTPCD

Objective To evaluate the efficacy of bypass surgery after failed endovascular treatment for arteriosclerosis obliterans of lower extremities.Methods Clinical data of 11 patients with arteriosclerosis obliterans of lower extremities who underwent lower limb artery bypass surgery after failed endovascular treatment at our center from 2017 to 2022 were retrospectively analyzed.Patients all experienced lower limb artery re-occlusion after one or more endovascular treatments,and lower limb artery bypass surgery was required to restore blood vessels.Rutherford staging and TASC Ⅱgrading were performed based on patient's symptoms and lesions.The age,gender,high-risk factors,number and method of previous endovascular treatments,anastomotic site location,bypass method,and bridge vessel patency rate of patients were analyzed.Results Among 11 patients,the lower limb artificial vessel bypass surgery was performed in 10 cases and lower limb artificial vessel+autologous great saphenous vein bypass surgery was performed in one case.The mean surgical time was 199±30.29 min(150-250 min).One case of lymphoma and one case of incision infection occurred during the perioperative period.Postoperative follow-up was 12-25 months,with a bridge vessel patency rate of 81.8％at 6 months and 63.3％at 12 months.Conclusion For patients with arteriosclerosis obliterans of lower extremities,open bypass surgery after failed endovascular treatment can be used as a blood flow reconstruction method.However,the damage to blood vessels caused by endovascular treatment and the poor basic condition of patients may result in relatively poor bridge vessel patency.