Corson J D, Hoballah J J, Kresowik T F, Sharp W J, Worsey M J, Synn A Y, Martinasevic M, Kury W N, Brummer M
Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City 52242.
Int Angiol. 1993 Jun;12(2):162-7.
We reviewed 284 consecutive in situ saphenous vein bypass procedures performed for limb salvage over a 66 month period. All procedures were performed using an open technique with a modified Mills retrograde valvulotome using an incision exposing the whole vein. Ninety-eight percent were to the infrageniculate level (18% below knee popliteal and 80% crural). All patients had preoperative B-mode saphenous vein mapping. Intraoperative arteriographic and continuous wave Doppler evaluations were done on each bypass. Routine color duplex imaging was performed on all bypassess postoperatively. Primary and secondary patency rates for all in situ bypassess at 48 months were 68% and 86%. The perioperative mortality was 2.5%. All deaths were secondary to cardiovascular causes. We believe that the open technique with a retrograde valvulotome provide satisfactory long-term patency, high operability and an excellent vein utilization rate.
我们回顾了在66个月期间为挽救肢体而连续进行的284例原位大隐静脉旁路手术。所有手术均采用开放技术，使用改良的米尔斯逆行瓣膜刀，通过暴露整条静脉的切口进行。98%的手术到达膝下水平（18%为腘窝以下，80%为小腿）。所有患者术前均进行了B型大隐静脉造影。术中对每个旁路进行动脉造影和连续波多普勒评估。术后对所有旁路进行常规彩色双功成像。所有原位旁路在48个月时的一期和二期通畅率分别为68%和86%。围手术期死亡率为2.5%。所有死亡均继发于心血管原因。我们认为，使用逆行瓣膜刀的开放技术可提供令人满意的长期通畅率、高可操作性和出色的静脉利用率。
