目的  为下肢动脉粥样硬化闭塞症（arterial  sclerosis obstruction，ASO）末期利用腓肠动脉构建流出道提供病理学及解剖学基础。方法  在11例膝上截肢的新鲜离体标本上向动脉内灌注红色乳胶，解剖观察腘动脉及腓肠动脉的病理改变，提出构建腓肠动脉流出道的设想，并对收治的9例末期ASO患者进行下肢动脉造影，示股动脉、腘动脉及分支均不显影；B超示腘动脉基本闭塞。行腘动脉探查术，完成腓肠动脉成形及股腘动脉旁路转流术。结果  解剖观察结果：①腘（胫）动脉管壁僵硬，动脉粥样斑块填满管腔。②腓肠动脉开口处分3种病变形态：开放型、膜式狭窄闭塞型及柱状闭塞型。③临床上对腓肠动脉开口处成形，建立腓肠动脉流出道，再行股腘动脉旁路转流术。结果显示术后临床症状消失，皮温逐渐回升，下肢溃疡两月内逐渐愈合。B超显示腓肠动脉代偿性扩张。结论  通过解剖及临床研究结果显示，腓肠动脉流出道的构建是解决末期ASO患者的有效途径之一。

        Objective  To provide pathologic and anatomic basis for constructing outflow tract adopting sural arteries at the end stage of arterial sclerosis obstruction(ASO).  Methods   The red emulsion was infused into the arteries of 11 fresh upper leg specimens getting from knee amputation, after that, the pathologic changes of sural and popliteal arteries were dissected and analyzed. As well, the construction of collateral outflow tract was proposed. For 9 patients of ASO, lower extremity arteriography was undertaken, which proved that, femoral, popliteal arteries and their branches were nonvisulized, while sonography showed fundamental obstruction of those arteries. And then exploration of artery were carried out, followed by sural arteries forming and the by-pass between femoral and popliteal arteries.  Results  Anatomic dissection showed that, ① the wall of popliteal artery was rigid, with atheromatous plaque stuffing the lumens;②the opening of sural arteries appeared three types: open type, membrane obstruction type and pillar obstruction type;③the clinical symptom disappeared, skin temperature turn warm gradually，lower limb ulcer healed, and sural arteries dilated, after the operation of construction of collateral outflow tract.  Conclusions  The anatomy and clinical research proves that, the construction of collateral outflow tract adopting sural arteries is feasible.