Iliofemoraler oder femorofemoraler Cross-over-Bypass

  • E. H. J. Paes
  • J. F. Vollmar
  • R. Prinz
Conference paper
Part of the Berliner Gefäßchirurgische Reihe book series (BERLINGEFÄß, volume 4)

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.

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.

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Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1992

Authors and Affiliations

  • E. H. J. Paes
    • 1
  • J. F. Vollmar
    • 2
  • R. Prinz
    • 2
  1. 1.Abteilung für GefäßchirurgieMarienhospital AachenAachenDeutschland
  2. 2.Abteilung für Gefäß-, Thorax- und HerzchirurgieKlinikum der Universität UlmDeutschland

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