Fligelstone L J, Salaman R A, Oshodi T O, Wright I, Pugh N, Shandall A A, Lane I F
Cardiff Vascular Unit, Department of Medical Bioengineering, University Hospital of Wales, United Kingdom.
J Vasc Surg. 1995 Nov;22(5):588-92. doi: 10.1016/s0741-5214(95)70044-7.
Flush saphenofemoral ligation, with multiple cosmetic stab phlebectomy, successfully treats saphenofemoral reflux and superficial varicosities. The long-term effect on the residual greater saphenous vein (GSV) requires evaluation.
Noninvasive triplex ultrasound assessment of the residual GSV for potential use as a vein graft was used. We evaluated the independent objective and subjective cosmetic outcomes. We also used analysis to determine the correlation between GSV reflux, symptoms, and cosmetic outcome.
Seventy-two limbs were assessed at a median follow-up of 4 years (interquartile range 3 to 5 years). Fifty-nine limbs had patent GSVs above and below the knee. The mean length patent was 51 cm, and the mean internal diameters above and below the knee were 3.6 and 2.8 mm, respectively. In 65% of cases the vein had suitable ultrasonic characteristics, suggesting that it would be suitable for use as a conduit for a vascular bypass graft. Sixty-two limbs were considered a symptomatic success and 61 an objective cosmetic success. There was no correlation between the symptomatic and cosmetic outcome and the presence of superficial GSV reflux (linear regression analysis).
These findings support the effectiveness of the procedure of flush saphenofemoral ligation and multiple stab phlebectomy with regard to cosmetic and symptomatic outcome and may preserve the GSV for use as an autologous bypass graft.
采用大隐静脉股静脉结扎术联合多处小切口静脉切除术，可成功治疗大隐静脉股静脉反流及浅表静脉曲张。需要评估该术式对残留大隐静脉（GSV）的长期影响。
采用无创三维超声评估残留GSV，以确定其作为静脉移植物的潜在用途。我们评估了独立的客观和主观美容效果。我们还进行分析以确定GSV反流、症状和美容效果之间的相关性。
在中位随访4年（四分位间距3至5年）时，对72条肢体进行了评估。59条肢体的膝关节上下大隐静脉通畅。通畅的平均长度为51 cm，膝关节上下的平均内径分别为3.6和2.8 mm。在65%的病例中，该静脉具有合适的超声特征，表明其适合作为血管搭桥移植物的管道。62条肢体在症状改善方面取得成功，61条肢体在客观美容效果方面取得成功。症状和美容效果与浅表GSV反流的存在之间无相关性（线性回归分析）。
这些研究结果支持大隐静脉股静脉结扎术联合多处小切口静脉切除术在美容和症状改善方面的有效性，并且可能保留大隐静脉以用作自体搭桥移植物。
