Hallin R W
Am J Surg. 1983 May;145(5):626-9. doi: 10.1016/0002-9610(83)90108-3.
Over a 2 year period, 34 limbs were revascularized in 33 patients. The in situ saphenous vein technique was used. Improved instrumentation and patency rates have encouraged the use of this method. Eighteen patients were insulin-dependent diabetics. The indication for operation was limb salvage in 25 limbs (73 percent). No vein was considered too small to use. The origin of 25 of the grafts were femoral and 9, popliteal. The termination of 15 of the grafts were popliteal, 11 tibial or peroneal, and 8 pedal. Of 12 limbs considered to be the most difficult to treat due to diabetes and accompanying poor runoff, 4 had a patent pedal arch. Initial graft patency was achieved in 94 percent of the limbs. Overall graft patency was 73 percent; femoropopliteal patency was 86 percent; and combined femoral, tibial, peroneal, and pedal patency was 64 percent. Learning the in situ bypass technique is tedious. The low thrombogenicity of the graft provides a temptation to extend operative indications. Use of the saphenous vein in situ can result in superior revascularization of the leg.
在两年期间，33例患者的34条肢体实现了血管再通。采用了原位大隐静脉技术。改进的器械和通畅率促使了该方法的应用。18例患者为胰岛素依赖型糖尿病患者。25条肢体（73%）的手术指征是挽救肢体。没有哪条静脉被认为太小而不能使用。25条移植物的起始部位为股部，9条为腘部。15条移植物的终止部位为腘部，11条为胫部或腓部，8条为足部。在因糖尿病及伴随的血流不佳而被认为最难治疗的12条肢体中，4条具有通畅的足弓。94%的肢体实现了初始移植物通畅。总体移植物通畅率为73%；股腘通畅率为86%；股、胫、腓和足部联合通畅率为64%。学习原位旁路技术很繁琐。移植物的低血栓形成性促使人们扩大手术指征。原位使用大隐静脉可使腿部实现更好的血管再通。
