Comparison Of Open Surgery And Minimally Invasive Surgery For Artificial Vascular Reocclusion After Femoro-popliteal Artery Bypass

Objective:To summarize the experience of our center in the treatment of artificial vascular reocclusion after femoro-popliteal artery bypass.The comparison of open surgery and minimally invasive surgery in the treatment of artificial vessel reocclusion after femoro-iliac artery bypass surgery provides a basis for the choice of clinical surgical methods.Method:A retrospective analysis of clinical data of 50 patients(50 limbs)undergoing vascular re-occlusion after femoral-popliteal artery bypass surgery from January 2015 to January 2019 in the Department of Vascular Surgery,China-Japan Union Hospital,Jilin University.Twenty-six patients underwent traditional open surgery(simple incision and thrombectomy,incision and thrombectomy + anastomosis / distal bypass,artificial vascular or autologous saphenous vein retransplantation),and twenty-four patients underwent minimally invasive intervention Surgery(small incision thrombus removal + balloon dilation / stent implantation,catheter thrombolysis / Rotarex aspiration thrombectomy + balloon dilatation / stent implantation),and follow-up for 1 year.Record the general information of the patient,and record the ankle brachial index of the patient before surgery,3 days after surgery and 3 months after surgery,and the second-stage target patency rate of target vessels at 3 months and 1 year after surgery Rutherford staging changes,bedtime after operation,length of hospital stay and incidence of adverse events.Statistical methods were used to compare the effectiveness and safety of the two surgical methods.Results:All 50 patients successfully completed open surgery or minimally invasive surgery and completed follow-up.Among them,there were 26 patients in the traditional open group.The ABI before operation,3 days after operation,and 3 months after operation were 0.38 ± 0.05,0.81 ± 0.07,and 0.75 ± 0.05,respectively.The patency rate of the target vessel at 3 months and 1 year after operation was 92.31% and 46.15%.The bedtime and length of hospital stay after operation were 147.08 ± 13.07 hours and 17.58 ± 3.16 days.The number of adverse events was three.In the minimally invasive intervention group,there are 24 patients.The ABI before surgery,3 days after surgery,and 3 months after surgery were 0.40 ± 0.06,0.80 ± 0.09,and 0.75 ± 0.08.The patency rate of the target vessels at 3 months and 1 year after operation was 91.67% and 45.83%.Postoperative bedtime and hospital stay were 25.88 ± 3.24 hours and 8.19 ± 1.68 days.The number of adverse events was 1.There was no significant difference in the general information,the ABI at 3 days,3 months after surgery,the patency rate of target vessels at 3 and 1 year after surgery,the Rutherford stage at 3 months after surgery,and the incidence of adverse events.The difference in ABI at 3 days and 3 months after surgery was statistically significant(P <0.05),and there were significant differences in bedtime and length of hospital stay between the two groups(P <0.05).Conclusion:1.Open surgery and minimally invasive surgery both are safe and effective in the short to medium term for artificial vascular reocclusion after femoro-popliteal artery bypass.2.Minimally invasive surgery has advantages over open surgery in shortening the postoperative bed time and hospital stay of patients.