Analysis Of Surgical Treatment Of Arteriosclerosis Occlusive Disease In Lower Extremity

Objective:Arteriosclerosis obliterans(ASO)is a common disease in vascular surgery.Its etiology is complex,its clinical manifestations are diverse,and its complications are more serious.The purpose of this study was to explore the experience of surgical treatment of lower extremity ASO,and to explore the clinical value of surgical treatment of this disease.Matterials and Methods:The clinical data of 168 patients with lower extremity arteriosclerosis obliterans treated in Department of vascular surgery in the First Affiliated Hospital of Bengbu Medical College from January 2010 to January 2016 were analyzed retrospectively.Results:A total of 168 patients were selected for the surgical treatment of arterial bypass,endovascular intervention,and endarterectomy.The postoperative follow-up rate was about 74%(124/168),and the average follow-up time was about 2.7 years(0.5-6 years).A total of 104 patients underwent arterial bypass surgery,Among them,for aorto iliac artery(femoral)artificial vascular bypass surgery in a total of 16 cases,There were 33 cases with femoral and popliteal artery bypass,42 cases with great saphenous vein bypass of femoral and popliteal artery,13 cases with femoral and femoral artery bypass.The recovery was good after operation.The average value of ABI after arterial bypass surgery was(0.68±0.11),which was significantly higher than that of preoperative Bypass(0.32±0.16),(P<0.05).There were 42 cases of femoral and popliteal artery bypass with autologous great saphenous vein,the patency rate was 37/42(88.1%)in one stage,while 33 cases were with artificial blood vessel,the patency rate of one stage was 27/33(81.8%).The two materials were compared with each other(p>0.05).A total of 50 patients were treated with intracavitary interventional therapy.the average value of ABI after operation was(0.79±0.22),compared with that before operation(0.47±0.26)(P<0.05).There were 23 cases of hybrid surgery.the average postoperative ABI was(0.64±0.13),compared with(0.36 ±0.27)before operation(P< 0.05).10 cases of iliac(femoral)arteria endarterectomy,2 cases of hematoma complicated by puncture site after intravascular interventional procedure,The symptoms of 6 patients with multiple segmental occlusion of the knee were not improved after intravascular interventional therapy,3 cases had to be amputated.There were 18 cases of two times incision and embolectomy and two vascular bypass grafting because of the occlusion of the great saphenous vein,the artificial blood vessel occlusion or the reappearance of the lesion vessels.19 cases of postoperative limb ischemia were found during the outpatient follow-up,and proximal or distal embolectomy was performed after emergency admission,1 cases of limb symptoms were not improved,and autologous great saphenous vein bypass was performed.13 patients were followed up with limb necrosis,so amputation was performed.Conclusions:Traditional arterial bypass surgery plays an irreplaceable role in the treatment of lower extremity arteriosclerotic obliteration.Endovascular therapy has been widely used because of its advantages of minimally invasive,good efficacy,high safety,good range of application and rapid postoperative recovery.The choice of artery bypass graft materials is helpful to improve the patency rate.