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Abstract：
Background and Objectives: Lower extremity arterial disease is one of the most prevalent manifestations of atherosclerosis. The results from numerous studies regarding the best revascularization method of an occluded superficial femoral artery have been conflicting. The aim of this study was to compare the patency of transvenous endovascular with open femoropopliteal bypass, both with vein and prosthetic grafts. To our knowledge, a direct patency comparison between transvenous endovascular and open femoropopliteal bypass has not been published. This could help elucidate which method is preferable and in which cases. Materials and Methods: Patients with complex TASC-C and D SFA lesions were offered endovascular transvenous or open bypass. A total of 384 consecutive patients with PAD requiring surgical treatment were evaluated for inclusion in this study. Three-year follow-up data were collected for 52 endovascular procedures, 80 prosthetic grafts, and 44 venous bypass surgeries. Bypass patency was investigated by Duplex US every 6 months. Kaplan-Meier plots were used to analyze primary, primary-assisted, and secondary patency for endovascular transvenous, autovenous, and prosthetic bypasses. Results: Primary, primary-assisted, and secondary patency in venous group at 3 years was 70.5%, 77.3%, and 77.3%, respectively. In the endovascular transvenous group, primary, primary-assisted, and secondary patency at 3 years was 46.2%, 69.2%, and 76.9%, respectively. The lowest patency rates at 3 years were noted in the prosthetic graft group with 22.5% primary, 26.6% primary-assisted, and 28.2% secondary patency. Conclusions: The saphenous vein is the best graft to perform in above-the-knee femoropopliteal bypass. Transvenous endovascular bypass is a viable option with comparable primary-assisted and secondary patency. Primary patency is substantially lower for endovascular transvenous compared to venous bypass. Patients treated with endovascular transvenous bypass will require a significant number of secondary procedures to provide optimal patency. Prosthetic grafts should only be used if no other option for bypass is available.
摘要：
背景与目的：下肢动脉疾病是动脉粥样硬化的最常见表现之一。关于闭塞的股浅动脉的最佳血运重建方法的众多研究结果相互矛盾。这项研究的目的是比较经静脉血管内和开放股pop搭桥术的通畅性。都有静脉和假体移植。据我们所知,经静脉血管内分流术和开放股动脉分流术之间的直接通畅性比较尚未发表.这可能有助于阐明哪种方法更可取，在哪些情况下。材料和方法：对TASC-C和DSFA复杂病变的患者进行血管内静脉或开放旁路。总共384名需要手术治疗的连续PAD患者被评估纳入本研究。收集了52例血管内手术的三年随访数据，80个假体移植物,和44次静脉搭桥手术.DuplexUS每6个月调查一次旁路通畅情况。Kaplan-Meier图用于分析原发性，初级辅助，血管内静脉二次通畅，自体静脉,和假肢旁路。结果：主要，初级辅助，3年静脉组的二次通畅率为70.5%，77.3%,和77.3%，分别。在血管内经静脉组，小学,初级辅助，3年的继发性通畅率为46.2％，69.2%,76.9%,分别。在假体移植组中，3年的通畅率最低，为22.5％，26.6％的初级援助，和28.2%的二级通畅。结论：大隐静脉是膝关节上股动脉旁路术的最佳移植物。经静脉血管内搭桥术是一种可行的选择，具有可比的初级辅助和次级通畅性。与静脉旁路相比，经血管内静脉的原发性通畅性明显较低。接受血管内经静脉旁路术治疗的患者将需要大量的二次手术以提供最佳的通畅性。只有在没有其他旁路选项时，才应使用假体移植物。
