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首页> 外文期刊>Vascular and endovascular surgery >Long-Term Limb Salvage and Amputation-Free Survival After Femoropopliteal Bypass and Femoropopliteal PTA for Critical Ischemia in a Clinical Cohort
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Long-Term Limb Salvage and Amputation-Free Survival After Femoropopliteal Bypass and Femoropopliteal PTA for Critical Ischemia in a Clinical Cohort

机译：在临床队列中临床缺血术后股骨头造质旁路和股骨质缺血后的长期肢体救生和无截肢生存

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Objective: This population-based retrospective cohort study investigates long-term results of femoropopliteal bypass and femoropopliteal endovascular intervention (PTA) in patients with critical ischemia, with focus on limb salvage and amputation-free survival. Methods: All patients who underwent femoropopliteal bypass or femoropopliteal PTA for critical ischemia without other simultaneous intervention between 1999 and 2013 were included. Stratification was according to treatment modality and symptoms, rest pain, or ischemic ulcer/gangrene. We assessed technical success, 30-day complications, length of stay, recurrent interventions, limb salvage, survival, and amputation-free survival in all patients. Results: We identified 292 operations in 264 patients, 140 bypass and 152 PTA. In 32 PTA cases, the patients were explicitly deemed unfit for bypass surgery. This group had significantly inferior technical success and limb salvage (P = .00). In other patients, technical success was 96% for bypass and 93% for PTA, while limb salvage after 5 years was 78% for bypass and 81% for PTA. Reoperation for local complications was performed in 16% after bypass and 2% after PTA (P = .00). Mean length of stay was 8 days after bypass and 1.9 days after PTA (P = .00). Conclusions: Long-term follow-up showed similar technical success and good limb salvage for both PTA and bypass patients in this clinical cohort. Patients who were unfit for bypass surgery had significantly inferior technical success and limb salvage. PTA was associated with shorter hospital stay and fewer reoperations for local complications. The findings support a PTA first strategy in all cases where technical success is likely.
机译：目的：基于人口的回顾性队列研究调查临界缺血患者患者股骨头造质旁路和股骨质模板血管内干预（PTA）的长期结果，重点是肢体救生和无截肢生存期。方法：包括1999年至2013年间无其他同时干预的关键缺血的股骨头造质旁路或股骨质缺血的所有患者。分层根据治疗方式和症状，休息疼痛或缺血性溃疡/坏疽。我们评估了技术成功，30天并发症，留下时间长，复发干预，肢体救生，生存和无截肢生存率。结果：我们在264名患者中确定了292个操作，140名旁路和152个PTA。在32种PTA病例中，患者明确地认为不适合绕过手术。该集团具有明显劣等的技术成功和肢体救赎（P = .00）。在其他患者中，PTA的旁路和93％的技术成功为96％，而PTA的肢体挽5是78％，PTA为81％。在PTA（P = 0.00）后，旁路后16％的局部并发症的重新进食在16％中进行（P = .00）。旁路后的平均入住时间为8天，PTA后1.9天（P = .00）。结论：长期随访表明，这种临床队列中PTA和旁路患者的PTA和旁路患者的良好技术成功和良好的肢体。不适合旁路手术的患者显着劣等劣等的技术成功和肢体挽救。 PTA与较短的住院住宿和局部并发症的重新进展有关。调查结果支持PTA第一策略，所有情况都有可能。

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