Moritz A, Grabenwöger F, Raderer F, Ptakovsky H, Magometschnigg H, Ullrich R, Staudacher M
II Chirurgische Universitätsklinik, University of Vienna, Austria.
Cardiovasc Surg. 1993 Oct;1(5):508-12.
Varicose veins are not generally used as arterial bypass grafts despite their physiological endothelial flow surface. The large, irregular diameter and the thin wall renders these veins inadequate. Experimental studies have shown that a considerable reduction in the diameter of veins can be achieved by external wrapping without the generation of obstructing folds of the vein wall. A Dacron mesh tube surrounding varicose veins was used as a bypass graft in 13 infrainguinal arterial reconstructions. Ligated larger side branches and connections of the mesh segments caused irregularities of the otherwise smooth flow surfaces. Ten grafts were patent after a mean follow-up of 17 months. Two grafts have remained patent despite severe outflow obstruction in one and proximal occlusion in the other; both underwent successful interventions. The antithrombogenic properties of these grafts were partly due to a marked increase of the vasa vasorum. Externally constricted varicose veins may be used as arterial bypass conduits with good intermediate-term patency.
尽管静脉曲张具有生理性内皮血流表面，但一般不将其用作动脉搭桥移植物。其直径大且不规则，管壁薄，使得这些静脉不适用。实验研究表明，通过外部包裹可使静脉直径显著减小，且不会产生阻碍静脉壁的褶皱。在13例腹股沟下动脉重建术中，使用了围绕静脉曲张的涤纶网网管作为搭桥移植物。结扎较大的侧支和网片段的连接导致原本光滑的血流表面出现不规则。平均随访17个月后，10例移植物通畅。尽管其中1例存在严重的流出道梗阻，另1例存在近端闭塞，但仍有2例移植物保持通畅；两者均接受了成功的干预。这些移植物的抗血栓形成特性部分归因于血管滋养管的显著增加。外部缩窄的静脉曲张可作为具有良好中期通畅率的动脉搭桥管道。
