von Jessen F, Rørdam P, Sillesen H H, Schroeder T V
Karkirurgisk afdeling RK, Rigshospitalet, København.
Ugeskr Laeger. 1992 May 11;154(20):1402-6.
Postoperative bypass surveillance can identify graft-related stenoses in 25% of grafts during the first two years after surgery. Correction of the stenoses before they lead to graft occlusion improves the patency significantly. Clinical assessment including distal pressure measurements is of poor sensitivity. Surveillance is best performed with color duplex scanning. Ideally, grafts are examined first after one to two months, thereafter every three months and, after one year, at intervals of six months. Graft surveillance beyond two years is hardly justified, as is the case with prosthetic grafts. Symptom-producing and tight stenoses should be corrected. Percutaneous transluminal angioplasty is appropriate for short stenoses, whereas stenoses longer than 2 to 3 cm are best treated surgically.
术后搭桥血管监测可在术后头两年内发现25%的移植血管相关狭窄。在狭窄导致移植血管闭塞之前进行纠正可显著提高通畅率。包括远端压力测量在内的临床评估敏感性较差。最好用彩色双功超声扫描进行监测。理想情况下，移植血管在术后1至2个月时先进行检查，此后每3个月检查一次，1年后每6个月检查一次。与人工血管一样，超过两年的移植血管监测几乎没有必要。有症状的严重狭窄应予以纠正。经皮腔内血管成形术适用于短段狭窄，而长度超过2至3厘米的狭窄最好通过手术治疗。
