The elective surgical revascularization was carried out in 162 cases with arteriosclerotic occlusive disease in the lower extremity during recent 6 years. The mean age at surgery was 68±9 years old. More than half of the cases (56.2 %) were complicated with other vascular diseases such as ischemic coronary artery disease (21.6 %) and cerebral infarction (9.3 %). The vascular lesion sites were terminal abdominal aorta area in 10 cases, iliac artery area in 117 cases and femoropoplitral artery area in 91 cases. Lesions in 2 areas were found in 85 cases. The anatomical bypass was performed in 135 cases, extra-anatomical bypass in 11 cases, patch angioplasty in 16 cases, and aorto-femoral artery bypass and femoropopliteal artery bypass in 36 cases. The surgical revascularization in 11 cases were sequentially carried out because of the exacerbation of lesions. Myocardial revascularization in 14 cases with ischemic coronary artery disease were additionally carried out. Although surgery-related death was not found, some postoperative complications developed such as bypass-graft thrombosis within postoperative 6 months in 10 cases, dehiscence of the abdominal wound in 5 cases, ileus in 3 cases, infection of Dacron graft in 4 cases and extremity-amputation in 3 cases. The final rate of the successful surgical revascularization was 98.4 % in the aorto-iliac artery area and 91.2 % in the femoro-popliteal artery area. From the above-mentioned results, it was suggested that bypass with Dacron graft in combination with the anti-coagulant therapy can be recommended for the revascularization in the arteriosclerotic occlusive disease in the lower extremity.
最近の下肢閉塞性動脈硬化症に対する血行再建手術の経験
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