Killewich L A, Fisher C, Bartlett S T
Department of Surgery, University of California, Davis, Medical Center, Sacramento.
J Cardiovasc Surg (Torino). 1990 Sep-Oct;31(5):662-7.
Surveillance of in situ saphenous vein bypass grafts with duplex scanning detects graft abnormalities which may lead to graft thrombosis. Correction of these defects, while grafts are still patent, potentially improves overall graft patency. In this study we compared color flow and conventional duplex to determine whether color flow provided additional information not obtainable by conventional duplex examination. The primary patency rate (patency maintained without intervention) for all 51 cases was 76% (39/51). The secondary patency rate (patency maintained by identification and correction of graft defects before failure) was 88% (45/51). Duplex scanning reduced the graft failure rate by 50%. Color flow and conventional duplex examination provided the same information regarding incipient graft failure. In 20 patients monitored with both techniques, the same number of proximal (100%) and distal (90%) anastomoses were imaged. The same number of graft defects (three vein graft stenoses, one proximal femoral artery stenosis) were identified. Velocity data obtained using the two techniques (peak systolic velocity in an area of stenosis and the duplex velocity ratio) were not always the same, making calculation of percent stenosis from this data inaccurate. Color flow duplex is useful in monitoring graft patency, but provides no additional information over that provided by conventional scanning.
使用双功扫描对原位隐静脉搭桥血管进行监测可检测到可能导致移植血管血栓形成的血管异常。在移植血管仍保持通畅时纠正这些缺陷，有可能提高移植血管的总体通畅率。在本研究中，我们比较了彩色血流成像和传统双功扫描，以确定彩色血流成像是否能提供传统双功检查无法获得的额外信息。所有51例患者的一期通畅率（无需干预即可维持通畅）为76%（39/51）。二期通畅率（在移植血管失败前通过识别和纠正血管缺陷来维持通畅）为88%（45/51）。双功扫描使移植血管失败率降低了50%。彩色血流成像和传统双功检查在早期移植血管失败方面提供了相同的信息。在20例同时采用两种技术进行监测的患者中，近端吻合口（100%）和远端吻合口（90%）成像的数量相同。识别出的移植血管缺陷数量相同（3处静脉移植血管狭窄，1处近端股动脉狭窄）。使用这两种技术获得的速度数据（狭窄区域的收缩期峰值速度和双功速度比）并不总是相同，因此根据这些数据计算狭窄百分比并不准确。彩色血流双功扫描在监测移植血管通畅方面是有用的，但并没有提供比传统扫描更多的额外信息。
