腹部大動脈・腸骨動脈領域の閉塞病変におけるExtraanatomic Bypass術の経験

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  • TREATMENT OF AORTOILIAC OCCLUSIVE DISEASE BY EXTRAANATOMIC BYPASS GRAFTING

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Sixty-four patients, who underwent revascularization for the treatment of arteriosclerotic occlusive lesions in the abdominal aorta and iliac artery, were divided into three groups: a TEA group consisting of 25 patients treated with thromboendarterectomy, an AB group consisting of 18 patients treated with anatomic bypass grafting and an EAB group consisting of 21 patients treated with extraanatomic bypass grafting. Comparison among these three groups revealed:<br>1) Extra-anatomic bypass grafting was carried out in relatively aged, severe cases showing advanced vascular lesions.<br>2) None of the patients from the AB group died in the early postoperative period, while 2 patients from the EAB group and 1 from the TEA group died in this period.<br>3) Long-term patency rate was 75%, 88.8% and 89.3% for the TEA, AB and EAB groups, respectively. Thus, extraanatomic bypass grasting resulted in favorable patency (the two cases in whom patency could not be maintained after surgery had occlusion in the superficial femoral artery).<br>The course of patients after extraanatomic bypass grafting was more favorable in the present study than in previous studies reported in the literature. Therefore, this form of surgery should be widely applied from now on. To further improve the long-term patency, this technigue needs to be supplemented by additional surgery such as revascularization of the femoral and popliteal arteries.

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