Moody A P, Edwards P R, Harris P L
Vascular Surgery Unit, Broadgreen Hospital, Liverpool, U.K.
Eur J Vasc Surg. 1992 Sep;6(5):509-11. doi: 10.1016/s0950-821x(05)80625-5.
In a prospective series of 74 femoro-popliteal vein grafts (34 in situ and 40 reversed), 22 strictures were identified by duplex scanning in 18 grafts (24.3%). Thirteen strictures were identified in 10 of 40 reversed grafts and 9 strictures were identified in 8 of 34 in situ grafts. Grafts were marked at operation using surgical clips at sites of all valves, tributaries, clamps and venotomies, since these have all been suggested as potential sources of graft strictures. These were prospectively studied as part of a detailed graft surveillance programme by intravenous digital subtraction angiography and duplex scanning. A total of 377 valves, 681 tributaries, 15 clamps and 2 venotomies were identified. Twenty-two strictures were detected in 18 grafts, an incidence of 24.3%, but only one lesions coincided with a specific marked area (a valve site). Duplex examination in 34 in situ grafts identified 10 residual valve cusps in seven grafts. In none of these was there any evidence of turbulence or flow disturbance, and none progressed to form a stricture. It is concluded that there is no correlation between valve sites, tributaries, clamp sites or residual valve cusps and the development of vein graft strictures.
在一项对74例股腘静脉移植术（34例原位移植和40例倒置移植）的前瞻性研究中，通过双功扫描在18例移植血管（24.3%）中发现了22处狭窄。在40例倒置移植血管中的10例发现了13处狭窄，在34例原位移植血管中的8例发现了9处狭窄。在手术时，使用手术夹对所有瓣膜、分支、血管夹和静脉切开部位进行标记，因为这些部位都被认为是移植血管狭窄的潜在来源。作为详细移植血管监测计划的一部分，通过静脉数字减影血管造影和双功扫描对这些部位进行了前瞻性研究。总共识别出377个瓣膜、681个分支、15个血管夹和2处静脉切开部位。在18例移植血管中检测到22处狭窄，发生率为24.3%，但只有一处病变与一个特定的标记区域（一个瓣膜部位）重合。对34例原位移植血管进行的双功检查在7例移植血管中发现了10个残留的瓣膜尖。在这些病例中，均未发现有血流紊乱或血流干扰的证据，也没有一例发展为狭窄。结论是，瓣膜部位、分支、血管夹部位或残留瓣膜尖与静脉移植血管狭窄的发生之间没有相关性。
