Gruss J D
J Chir (Paris). 1977;113(1):39-42.
During May's femoral by-pass, one should avoid by sapheno-popliteal anastomosis, obstruction of the femoral vein damaged by the post-thrombotic syndrome. After the early work of Kunlin, arterio-venous fistulas are often found in reconstructive venous surgery. By making a transverse end-to-side anastomosis between the main peripheral saphenous vein and the posterior tibial artery behind the internal malleolus, one may obtain a protective effect on the sapheno-popliteal anastomosis, increasing the blood flow towards the main saphenous vein across the perforating veins down to the deep leg veins. The protective effect of the arterio-venous fistula seems to be of interest during inactivity of the muscular pump of the calf (postoperative phase and during rest at night).
在进行股动脉搭桥术时，应避免采用隐静脉-腘静脉吻合，以免阻塞因血栓形成后综合征而受损的股静脉。在昆林早期的工作之后，动静脉瘘在重建性静脉手术中经常被发现。通过在内踝后方将主要的外周隐静脉与胫后动脉进行横向端侧吻合，可以对隐静脉-腘静脉吻合起到保护作用，增加经穿静脉流向主要隐静脉并向下至小腿深静脉的血流量。在小腿肌肉泵不活动时（术后阶段以及夜间休息时），动静脉瘘的保护作用似乎值得关注。
