Summary
Retrospective clinical analysis of 63 patients (group I) treated with iliofemoral and 31 patients (group II) with femorofemoral cross-over bypass is repeated. The indication in both groups was a unilateral iliac obstruction in aged patients with high operative risk. In group I, 90% of the patients with ischemic rest pain or skin lesions were treated successfully; in group II only 65% resulted in healing of the ischemic skin lesions respectively disappearance of the ischemic rest pain. The cumulative patency rate after 1 and 5 years amounted in group I to 94% and 86%, in group II to 90% resp. 75% (p < 0.05). The limb salvage rate during the same interval amounted to 94% and 91% in group I versus 83% and 77.2% in group II (p < 0.05). Because of the lesser number of complications (improved hemodynamics, lower number of infections) and better longterm results the iliofemoral cross-over is preferred. Another important advantage of this procedure is the possibility to correct a concommitant localized stenosis of the donor artery in the case of bilateral iliac obstructive lesions.
Zusammenfassung
In einer retrospektiven klinischen Analyse wird über 63 Patienten mit einem iliofe-moralen (Gruppe I) und 31 Patienten mit femorofemoralem (Gruppe II) Cross-over-Bypass berichtet. Wichtigste Indikationen waren in beiden Gruppen unilaterale Bek-kenarterienverschlüsse bei multimorbiden Patienten im höheren Lebensalter. In Gruppe I gelang bei 90% der Patienten mit einem AVK-Stadium III und IV eine Rückführung in ein AVK-Stadium I/II: In Gruppe II war dies bei 65% der Fall. Die kumulative Offenheitsrate betrug nach einem bzw. fünf Jahren in Gruppe I 94 bzw. 86%, in Gruppe II 90 bzw. 75% (p < 0,05); die „limb salvage rate“betrug in Gruppe I 94% bzw. 91% und in Gruppe II 83% bzw. 77,2% (p < 0,05). Dank der geringeren Störanfälligkeit (verbesserte Hämodynamik, geringere Zahl von Wundheilungsstörungen) und der Möglichkeit der simultanen Mitkorrektur der Spenderarterie verdient der iliofemorale Cross-over-Bypass klare Priorität.
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© 1992 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt
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Paes, E.H.J., Vollmar, J.F., Prinz, R. (1992). Iliofemoraler oder femorofemoraler Cross-over-Bypass. In: Hepp, W. (eds) Aortoiliakale Verschlußprozesse. Berliner Gefäßchirurgische Reihe, vol 4. Steinkopff. https://doi.org/10.1007/978-3-642-72484-8_12
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DOI: https://doi.org/10.1007/978-3-642-72484-8_12
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