Davies A H, Magee T R, Thompson J F, Varga Z, Lamont P M, Baird R N, Horrocks M
Department of Vascular Surgery, Bristol Royal Infirmary.
Ann R Coll Surg Engl. 1993 May;75(3):178-80.
During femorodistal bypass angioscopy can be used in vein graft preparation allowing valve lysis and the identification of tributaries under direct vision. A total of 30 patients have undergone angioscopic assisted femorodistal bypass using either an Olympus or Stortz system. Nineteen patients have undergone full vein mobilisation and valve lysis under direct vision. Eleven patients had in situ bypass with ligation of tributaries, identified by the angioscope, through small stab incisions. No evidence of fistula or retained valve cusps was found by subsequent duplex scanning and arteriography. One of these grafts failed at 6 days due to an unrecognised outflow stenosis. The mean hospital stay after operation for this latter group of patients was 5.2 days (range 4.4-6.0 days) compared with 9.5 days (8.6-10.3 days) in a historical group of 30 patients (P < 0.001). Angioscopy is a useful aid in the performance of femorodistal bypass. Early experience suggests that hospital stay may be reduced by angioscope assisted in situ femorodistal bypass because of the minimal dissection involved.
在股腘动脉搭桥术中，血管镜可用于静脉移植物的制备，能在直视下进行瓣膜溶解并识别分支血管。共有30例患者接受了使用奥林巴斯或史托斯系统的血管镜辅助股腘动脉搭桥术。19例患者在直视下进行了全静脉游离和瓣膜溶解。11例患者通过血管镜识别分支血管，经小切口结扎后进行原位搭桥。随后的双功超声扫描和动脉造影未发现瘘管或残留瓣膜尖的证据。其中1例移植物在术后6天因未识别出的流出道狭窄而失败。后一组患者术后的平均住院时间为5.2天（范围4.4 - 6.0天），而30例历史对照组患者的平均住院时间为9.5天（8.6 - 10.3天）（P < 0.001）。血管镜有助于股腘动脉搭桥术的实施。早期经验表明，血管镜辅助原位股腘动脉搭桥术可能会减少住院时间，因为其所涉及的解剖操作极少。
