目的 總結鎖骨下動脈-頸內動脈人工血管通路輔助頸內動脈支架置入術治療復雜頸總動脈閉塞的 可行性和有效性。 方法 在同側鎖骨下動脈-頸內動脈人工血管搭橋建立腔內治療的通路后，行頸內動脈支架置 入治療復雜頸總動脈閉塞，總結其可行性。 結果 該例患者的手術時間為125 min，術中出血量為10 mL。行鎖骨 下動脈-頸內動脈人工血管通路輔助頸內動脈支架置入術后，頸內動脈血流恢復通暢。術后沒有過度灌注綜合征 及其他并發癥發生。術后6 d 患者康復出院，出院后隨訪7 個月，未再發生頭暈及頭痛。 結論 鎖骨下動脈- 頸內 動脈人工血管通路輔助頸內動脈支架置入術適用于治療復雜頸總動脈閉塞患者。
Objective To summarize the efficacy of lower-extremity arterio-arterial graft (AAG). Methods A retrospective analysis was performed on the clinical data and follow-up outcomes of patients who received lower-extremity AAG in Longhua Hospital Shanghai University of Traditional Chinese Medicine between August 2015 and September 2021. Results A total of 7 patients with AAG were enrolled, with a mean age of (52.1±12.5) years, including 6 females. Six patients received common femoral artery-deep femoral artery AAG, and 1 patient received common femoral artery-superficial femoral artery AAG. All grafts were successfully cannulated for hemodialysis. The follow-up duration ranged from 2 to 77 months, with a mean of (31.6±26.9) months. No limb ischemia occurred during follow-up. Graft thrombosis developed in 6 patients, and stenosis was observed in 6 patients (including distal arterial anastomotic stenosis and cannulation site stenosis). Pseudoaneurysms formed in 4 patients, among whom 1 was complicated by local infection. The 2-year secondary access patency rate was 83.3%. Conclusions Lower-extremity AAG, especially common femoral artery-deep femoral artery AAG, is associated with a low incidence of distal limb ischemia and acceptable patency rates, which can prolong patients’ hemodialysis survival. However, pseudoaneurysms at cannulation sites remain a concern. This alternative access can be cautiously selected in clinical practice.