Contreras F, Polterauer P, Kretschmer G, Kovats E, Waneck R, Schemper M, Wagner O
Surg Gynecol Obstet. 1984 Apr;158(4):339-43.
Our results seem to demonstrate that, even when healthy or arteriosclerotic arteries tolerate knee flexion without any impairment of blood flow, all bypass materials, to a certain extent, have a tendency toward morphologic changes, such as kinking, looping, stenosis and decrease of peripheral blood flow. Reocclusion in below-knee reconstruction, which cannot be explained by poor outflow situation or technical faults, might be related to the graft material used as well as hemodynamic changes caused by flexion of the knee joint. With the use of ASV grafts, these changes are minimal and of little or no clinical importance; when HUV is used, these changes are more distinctive and might, in some instances, be the cause of reocclusion. This could explain the difference in the late results with the use of ASV or HUV. The results of reinforced PTFE still await evaluation. However, it should be kept in mind that the results in addition to the already mentioned influences are also caused by neointima proliferation and progression of the disease.
我们的结果似乎表明，即使健康或动脉粥样硬化的动脉能够耐受膝关节屈曲而不出现任何血流受损的情况，但所有旁路材料在一定程度上都有形态学改变的倾向，如扭结、成袢、狭窄以及外周血流减少。膝下重建中的再闭塞，若无法用流出道不佳或技术失误来解释，则可能与所用的移植材料以及膝关节屈曲引起的血流动力学变化有关。使用自体大隐静脉（ASV）移植物时，这些变化极小，几乎没有或完全没有临床意义；使用人脐静脉（HUV）时，这些变化更为明显，在某些情况下可能是再闭塞的原因。这可以解释使用ASV或HUV时远期结果的差异。强化聚四氟乙烯（PTFE）的结果仍有待评估。然而，应该记住的是，除了上述影响外，结果还由新生内膜增殖和疾病进展所导致。
