Donaldson M C
Arch Surg. 1984 Jul;119(7):766-9. doi: 10.1001/archsurg.1984.01390190010002.
A policy of preference for the in situ saphenous vein was adopted for all patients requiring bypass grafting below the knee. In an initial series of 25 operations, technical complications occurred in eight cases (32%), including venographic extravasation, vein injury during valve lysis, and early graft occlusions due to incomplete valve lysis and routing under tension past the hamstring tendons. Early loss of tibial outflow vessels occurred twice, with retrieval of embolic debris possibly shed from the graft. In spite of these events, at an average follow-up of ten months, 21 grafts were open (84% patency). Two occlusions occurred in patients who suffered operative complications, and another graft was lost after rethrombosis of a donor axillobifemoral prosthesis. Acceptable patency in spite of technical mishaps early in my experience encourages continued efforts to master the in situ method.
对于所有需要在膝下进行搭桥手术的患者，均采用优先使用原位大隐静脉的策略。在最初的25例手术系列中，8例（32%）出现了技术并发症，包括静脉造影剂外渗、瓣膜松解时静脉损伤，以及由于瓣膜松解不完全和在张力下绕过腘绳肌腱布线导致的早期移植物闭塞。胫前流出血管早期丧失发生了两次，可能是从移植物上脱落的栓塞碎片被取出。尽管发生了这些情况，但在平均10个月的随访中，21条移植物通畅（通畅率84%）。两名患者因手术并发症出现了移植物闭塞，另一例移植物在供体腋股人工血管再次血栓形成后丧失。尽管在我早期的经验中出现了技术失误，但可接受的通畅率鼓励继续努力掌握原位方法。
