Mellière D
Service de Chirurgie Vasculaire, Hôpital Henri-Mondor, Créteil.
J Mal Vasc. 1994;19(3):216-21.
The greater saphenous veins (GSV) are the best substitute for arterial in several locations and are often the only convenient graft. As patients consult for varicose veins at an increasingly younger age and since surgery for varicose veins has become quite popular, there is a risk of unneeded destruction of saphenous veins which will be lacking later. Approximately 80% of the GSV veins in patients consulting for varcosities are normal, slightly dilated or simply have one or more minor areas of dilatation. A special Dacron sheath can be used to maintain these areas of dilatation. The cases presented here demonstrate that these bypass remain patent and that non-sheated areas do not undergo undue dilatation. This technique makes it possible to widen the use of GSV in a larger number of patients with varicose veins. Consequently, it is necessary to verify the caliber of the trunk of GSV during the echo-Doppler examination before treating patients with varicose veins. Suitable GSV should be conserved during initial treatment. Patients should be well informed of the rationale for such decisions, especially concerning the chronological delay between the occurrence of venous varicosities and arterial disease.
大隐静脉（GSV）在多个部位是动脉的最佳替代物，且常常是唯一方便的移植物。由于患者咨询静脉曲张的年龄越来越小，且静脉曲张手术已相当普遍，存在大隐静脉被不必要地破坏的风险，而后续可能会需要它。在咨询静脉曲张的患者中，约80%的大隐静脉是正常的、轻度扩张的，或者仅仅有一个或多个轻度扩张区域。可以使用一种特殊的涤纶鞘来维持这些扩张区域。这里展示的病例表明，这些旁路保持通畅，且未加鞘的区域不会过度扩张。这项技术使得在更多静脉曲张患者中扩大大隐静脉的使用成为可能。因此，在治疗静脉曲张患者之前，有必要在超声多普勒检查期间核实大隐静脉主干的管径。在初始治疗期间应保留合适的大隐静脉。应让患者充分了解此类决策的依据，特别是关于静脉静脉曲张出现与动脉疾病之间的时间间隔。
