članak: 1 od 1  
Srpski arhiv za celokupno lekarstvo
2004, vol. 132, br. 5-6, str. 157-162
jezik rada: srpski
neklasifikovan
doi:10.2298/SARH0406157D

Aksilobifemoralni bajpas
aUniverzitet u Beogradu, Medicinski fakultet, Klinički centar Srbije
bHirurško odeljenje, Opšta bolnica, Kikinda

e-adresa: lazard@eunet.yu

Sažetak

Aksilofemoralni bajpas podrazumeva spajanje aksilarne i femoralne arterije graftom koji je postavljen potkožno. Najčešće ce dodatnim graftom, koji je takođe potkožno postavljen, ovaj graft spaja sa kontralateralnom femoralnom arterijom i tada govorimo o tzv. aksilobifemoralnom bajpasu. Ova ekstra anatomska procedura je alternativa standardnim rekonstrukcijama aortoilijačne regije kada su one kontraindikovane usled opštih ili lokalnih razloga. Analizirano je 37 ovakvih procedura. One su izvedene kod 28 bolesnika sa okluzivnom bolešću aortoilijačnog segmenta, koji su zbog komorbiditeta bili visokorizični: kod jednog bolesnika sa rupturom jukstarenalne aneurizme abdominalne aorte, kod pet bolesnika sa aortoenteričnom fistulom i dva bolesnika sa jatrogenom povredom abdominalne aorte. Rani postoperacioni mortalitet iznosio je 13,5%. Preživeli bolesnici su nadgledani u periodu od šest meseci do 17 godina (prosečno 40,1 mesec). Rezultati su pokazali da je aksilobifemoralni bajpas dobra alternativa aortobifemoralnom bajpasu, imajući u vidu mortalitet i udaljenu prohodnost. Autori smatraju da je aksilobifemoralna rekonstrukcija pre svega indikovana u slučajevima gde je zbog stanja u abdomenu (infekcija, priraslice, komorbiditet) anatomska rekonstrukcija kontraindikovana ili tehnički teško izvodljiva, odnosno kod visokorizičnih bolesnika kod kojih je očekivani životni vek ograničen.

Ključne reči

aksilofemoralni bajpas

Reference

Absolon, K.B., Freant, L., Newsome, D., Kim, S.C., Oboler, A. (1975) Extrathoracic axillary-iliac bypass substitution of a resected descending thoracic aorta. Surgery, 77(2): 275-9
Alexander, R.H., Selby, J.H. (1980) Axillofemoral bypass grafts using polytetrafluoroethylene. South Med J, 73(10): 1325-9, 1332
Allison, H.F., Terblanche, J., Immelman, E.J., de Villiers, D.R., Dent, D.M., Louw, J.H. (1985) Axillofemoral bypass. A 2-decade experience reviewed. S Afr Med J, 68(8): 559-62
Ascer, E., Veith, F.J., Gupta, S.K., Scher, L.A., Samson, R.H., White-Flores, S.A., Sprayregen, S. (1985) Comparison of axillounifemoral and axillobifemoral bypass operations. Surgery, 97(2): 169-75
Bacourt, F., Koskas, F. (1992) Axillobifemoral bypass and aortic exclusion for vascular septic lesions: A multicenter retrospective study of 98 cases. French University Association for Research in Surgery. Ann Vasc Surg, 6(2): 119-26
Blaisdell, F.W., Pevec, W.C. (1995) Extra-anatomic bypass grafting. u: Dean R.H., Yao J.S., Brewster D.S. (ur.) Current diagnosis & treatment in vascular surgery, London, itd: Prentice Hall International
Blaisdell, F.W., Hall, A.D. (1963) Axillary-femoral artery bypass for lower extremity ischemia. Surgery, 54: 563-8
Chang, J.B. (1986) Current state of extraanatomic bypasses. Am J Surg, 152(2): 202-5
Christenson, J.T., Broome, A., Norgren, L., Eklof, B. (1986) The late results after axillo-femoral bypass grafts in patients with leg ischaemia. J Cardiovasc Surg (Torino), 27(2): 131-5
Cormier, J.M., Bacourt, F. (1970) Axillo-femoral anastomosis (34 cases). J Chir (Paris), 100(6): 479-92
Courbier, R., Jausseran, J.M., Bergeron, P. (1980) Axillofemoral bypass, material of choice. Marseill Chir, 12, str. 244-46
Davidovic, L., Lotina, S., Vojnovic, B., Kostic, D., Markovic, D., Markovic, M., Jakovljevic, N., Simic, T. (1999) Aorto-bifemoral grafting: Factors influencing late results. Angology and Vascular Surgery, 5(2), str. 85-95
Davidović, L.B., Spasić, D.M., Lotina, S.I., Kostić, D.M., Činara, I.S., Cvetković, S.D., Đorić, P.M. (2001) Aorto-enterične fistule. Srpski arhiv za celokupno lekarstvo, vol. 129, br. 7-8, str. 183-193
de P., Hepp, W. (1991) Present role of extraanatomic bypass graft procedures for aortoiliac occlusive disease. Int Angiol, 10(4): 224-8
DeAvila, R., Doyle, J., Heaney, J.P. (1966) Axillary-femoral bypass. Arch Surg, 92(1): 118-9
DeLaurentis, D.A., Sala, L.E., Russell, E., McCombs, P.R. (1978) Twelve year experience with axillofemoral and femorofemoral bypass operations. Surg Gynecol Obstet, 147(6): 881-7
Donaldson, M.C., Louras, J.C., Bucknam, C.A. (1986) Axillofemoral bypass: A tool with a limited role. J Vasc Surg, 3(5): 757-63
el-Massry S., Saad, E., Sauvage, L.R., Zammit, M., Davis, C.C., Smith, J.C., Rittenhouse, E.A., Fisher, L.D. (1993) Axillofemoral bypass with externally supported, knitted Dacron grafts: A follow-up through twelve years. J Vasc Surg, 17(1): 107-14; di
Eugene, J., Goldstone, J., Moore, W.S. (1976) Fifteen-year experience with subcutaneous bypass grafts for lower extremity ischmeia. Ann Surg, 181:424
Foster, M.C., Mikulin, T., Hopkinson, B.R., Makin, G.S. (1986) A review of 155 extra-anatomic bypass grafts. Ann R Coll Surg Engl, 68(4): 216-8
Harris, E.J., Taylor, L.M., McConnell, D.B., Moneta, G.L., Yeager, R.A., Porter, J.M. (1990) Clinical results of axillobifemoral bypass using externally supported polytetrafluoroethylene. J Vasc Surg, 12(4): 416-20; di
Hepp, W., de Jonge, K., Pallua, N. (1988) Late results following extra-anatomic bypass procedures for chronic aortoiliac occlusive disease. J Cardiovasc Surg (Torino), 29(2): 181-5
Johnson, W.C., Logerfo, F.W., Vollman, R.W., Corson, J.D., O'Hara, E.T., Mannick, J.A., Nabseth, D.C. (1977) Is axillo-bilateral femoral graft an effective substitute for aortic-bilateral iliac/femoral graft?: An analysis of ten years experience. Ann Surg, 186(2): 123-9
Kenney, D.A., Sauvage, L.R., Wood, S.J., Berger, K., Davis, C.C., Smith, J.C., Rittenhouse, E.A., Hall, D.G., Mansfield, P.B. (1982) Comparison of noncrimped, externally supported (EXS) and crimped, nonsupported Dacron prostheses for axillofemoral and above-knee femoropopliteal bypass. Surgery, 92(6): 931-46
Levy, J.B. (1974) Les pontages atipiques dans la chirurgie des arteriopathies obliterantes des membres inférieurs. J Chir, 107 (2), str. 189-204
Logerfo, F.W., Johnson, W.C., Carson, J.D., i dr. (1977) A comparison of the late patency rates of axillobilateral and axillounilateral femoral grafts. Surgery, 81, str. 33-40
Lotina, S. (1983) Alternativni putevi (extraanatomski bypass) u revaskularizaciji aorto-ilio-femoralnih arterijskih lezija. Beograd: Medicinski fakultet, doktorska disertacija
Marty, A.C., Alrić, P., Prudhokke, M., Picard, F. (1996) Bilateral splenorenal bypass and axillofemoral graft for management of juxtarenal mycotic aneurysm. Cardiovasc Surg, 4(3): 331-4
Mason, R.A., Smirnov, V.B., Newton, G.B., Giron, F. (1989) Alternative procedures to aortobifemoral bypass grafting. J Cardiovasc Surg (Torino), 30(2): 192-7
Matesanz, J., Acin, F., Tanners, S. (1980) Extra-anatomic bypas: Clinical and hemodynamic results. u: Bircks W., Osteneyc J., Sehlte H.D. (ur.) Cardiovascular surgery, Berlin, itd: Springer Verlag
McKinsey, J.F. (1995) Extra-anatomic reconstruction. Surg Clin North Am, 75(4): 731-40
Mii, S., Mori, A., Sakata, H., Kawazoe, N. (1998) Fifteen-year experience in axillofemoral bypass with externally supported knitted Dacron prosthesis in a Japanese hospital. J Am Coll Surg, 186(5): 581-8
Mohan, C.R., Sharp, W.J., Hoballah, J.J., Kresowik, T.F., Schueppert, M.T., Corson, J.D. (1995) A comparative evaluation of externally supported polytetrafluoroethylene axillobifemoral and axillounifemoral bypass grafts. J Vasc Surg, 21(5): 801-8; dis
Moneta, G.L., Taylor, L.M., Yeager, R.A., Edwards, J.M., Nicoloff, A.D., McConnell, D.B., Porter, J.M. (1998) Surgical treatment of infected aortic aneurysm. Am J Surg, 175(5): 396-9
Moore, W.S., Hall, A.D. (1970) Late suture failure in the pathogenesis of anastomotic false aneurysms. Ann Surg, 172(6): 1064-8
Neutzil, D.F., Meszoely, I., Tarpley, J., Narsland, T.C. (1998) Aortoiliac occlusive disease and gastrointestinal malignancy: Changing therapeutic options. Ann Surg, 64(4), str. 293-7
Oblath, R.W., Green, R.M., DeWeese, J.A., Rob, C.G. (1978) Extra-anatomic bypass of the abdominal aorta: Management of postoperative thrombosis. Ann Surg, 187(6): 647-52
Passman, M.A., Taylor, L.M., Moneta, G.L., Edwards, J.M., Yeager, R.A., McConnell, D.B., Porter, J.M. (1996) Comparison of axillofemoral and aortofemoral bypass for aortoiliac occlusive disease. J Vasc Surg, 23(2): 263-9; dis
Pietri, P., Pancrazio, F., Adovasio, R., Sichel, L., Campanelli, G., Briganti, P.F. (1987) Long term results of extra anatomical bypasses. Int Angiol, 6(4): 429-33
Ray, L.I., O'Conor, J.B., Davis, C.C., i dr. (1979) Axillofemoral bypas: A critical reapproach of its role in the management of aortoiliac occlusive disease. Ann J Surg, 138, str. 117-28
Rutherford, R.B., Patt, A., Pearce, W.H. (1987) Extra-anatomic bypass: A closer view. J Vasc Surg, 6(5): 437-46
Rutherford, R.B., Midel, M.B. (1995) Extra-anatomic bypass in vascular surgery. Philadelphia, itd: W.B. Saunders
Savrin, R.A., Record, G.T., McDowell, D.E. (1986) Axillofemoral bypass. Expectations and results. Arch Surg, 121(9): 1016-20
Schultz, G.A., Sauvage, L.R., Mathisen, S.R., Mansfield, P.B., Smith, J.C., Davis, C.C., Hall, D.G., Rittenhouse, E.A., Kowalsky, T.E. (1986) A five- to seven-year experience with externally-supported Dacron prostheses in axillofemoral and femoropopliteal bypass. Ann Vasc Surg, 1(2): 214-24
Sheiner, N.M. (1978) Peripheral vascular surgery: Alternate anatomical pathways and the use of allograft veins as arterial substitutes. u: Wilson S.E., Van Wagenen P., Passaro E. Jr (ur.) Current Problems in Surgery: Arterial infection, Year Book Medical Publishers
Taylor, L.M., Park, T.C., Edwards, J.M., Yeager, R.A., McConnell, D.C., Moneta, G.A., Porter, J.M. (1994) Acute disruption of polytetrafluoroethylene grafts adjacent to axillary anastomoses: A complication of axillofemoral grafting. J Vasc Surg, 20(4): 520-6; dis
Wittens, C.H., van Houtte, H.J., van Urk, H. (1992) Winner of the ESVS Prize 1991. European Prospective Randomised Multi-centre Axillo-bifemoral Trial. Eur J Vasc Surg, 6(2): 115-23
Yeager, R.A., Taylor, L.M., Moneta, G.L., Edwards, J.M., Nicoloff, A.D., McConnell, D.B., Porter, J.M. (1999) Improved results with conventional management of infrarenal aortic infection. J Vasc Surg, 30(1): 76-83