假体股腘动脉旁路术后双超声监测的作用。

IF 2.4 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Michaela Kluckner, Wolfgang Hitzl, David Wippel, Laura Schönherr, Sabine Wipper, Leonhard Gruber, Florian K Enzmann
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引用次数: 0

摘要

背景:目前关于腹股沟下搭桥术后随访的指南建议进行临床检查,包括病史、脉搏触诊和踝关节-肱指数评估。根据指南,由于缺乏证据,双面超声可能会或可能不推荐。关于这一主题的数据很少,特别是在假体旁路手术后。患者和方法:回顾性分析了181例股骨腘动脉搭桥术后的超声监测结果。评估了流入血管、吻合血管、旁路血管和流出血管的流速和流型。主要终点是原发性通畅,而主要辅助和继发性通畅以及无截肢生存是次要终点。结果:通过应用Fine-Gray模型,确定了5个超声标准增加了原发性通畅丧失的风险。旁路和腘动脉单相血流模式的危险比分别为2.0 (95% CI: 1.26-3.1, p= 0.003)和1.7 (95% CI: 1.09-2.64, p= 0.02)。结论:股腘假体旁路术后超声监测可以识别与较低的通畅率和无截肢生存率相关的因素。这些发现可以帮助发现旁路闭塞风险较高的患者,并可能改善其预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of duplex ultrasound surveillance after prosthetic femoropopliteal bypass.

Background: Current guidelines on the follow-up after infrainguinal bypass recommend clinical examination with history, pulse palpation and ankle-brachial-index assessment. Depending on the guideline, duplex ultrasound may or may not be recommended due to the lack of evidence. Data on this topic is sparse, especially after prosthetic bypass. Patients and methods: In a retrospective single-centre analysis, ultrasound surveillance examinations of 181 patients after femoropopliteal prosthetic bypass were analysed. Flow-velocities and flow-patterns of the inflow, anastomoses, the bypass as well as the outflow vessels were evaluated. The primary endpoint was primary patency, while primary-assisted and secondary patency as well as amputation-free survival were secondary endpoints. Results: By applying the Fine-Gray Model five ultrasound criteria were identified to increase the risk of loss of primary patency. A monophasic flow-pattern of the bypass as well as the popliteal artery showed a hazard-ratio of 2.0 (95% CI: 1.26-3.1, p=.003) and 1.7 (95% CI: 1.09-2.64, p=.02), respectively. A peak systolic velocity <60cm/sec of the deep femoral artery was significantly associated with loss of primary patency (p=.025). Decrease of inflow velocity as well as the deep femoral artery during follow-up were also significantly connected to loss of primary patency (p<.001). Primary-assisted and secondary patency as well as amputation-free survival were significantly associated with the waveform in the bypass and the popliteal artery (p<.001, p=.011, p=.031, p=.013). Conclusions: Ultrasound surveillance after femoropopliteal prosthetic bypass can identify factors associated with lower patency rates and amputation-free survival. These findings can help detect patients at higher risk of bypass occlusion and may improve their outcome.

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来源期刊
CiteScore
3.90
自引率
11.10%
发文量
61
审稿时长
1 months
期刊介绍: Vasa is the European journal of vascular medicine. It is the official organ of the German, Swiss, and Slovenian Societies of Angiology. The journal publishes original research articles, case reports and reviews on vascular biology, epidemiology, prevention, diagnosis, medical treatment and interventions for diseases of the arterial circulation, in the field of phlebology and lymphology including the microcirculation, except the cardiac circulation. Vasa combines basic science with clinical medicine making it relevant to all physicians interested in the whole vascular field.
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