Puppinck P, Habi K, Ducasse E, Espagne P
Unité de Pathologie Vasculaire, C.H. Saint-Philibert, Lille.
J Mal Vasc. 1997 Jul;22(3):162-7.
Correct evaluation of the venous network before arterial revascularization is required to avoid unsuccessful explorations, underestimation of calibre because of spastic reactions to dissection and use of defective veins with unrecognized parietal or intraluminal lesions. The homolateral internal saphenous vein cannot be used in 10 to 30% of cases. Success of venous bypass is 30 to 40% greater than with prosthetic implants. Other veins can be used including the contralateral internal saphenous vein, external saphenous veins and veins from the upper limbs. Clinical evaluation is insufficient. Phlebography provides good results but is an aggressive exploration with certain limitations compared with duplex Doppler. Its potential complications are also absent with ultrasound exploration. Duplex Doppler is thus the first-line choice. Close coordination between the angiologist and the surgeon is essential to compare the exact measurements obtained preoperatively and the surgical findings, particularly concerning the venous calibre. Correction coefficients may then be established.
在进行动脉血运重建之前，需要对静脉网络进行正确评估，以避免探查失败、因对解剖的痉挛反应导致管径估计不足以及使用存在未被识别的壁层或腔内病变的有缺陷静脉。在10%至30%的病例中，同侧大隐静脉无法使用。静脉搭桥的成功率比使用人工移植物高30%至40%。还可以使用其他静脉，包括对侧大隐静脉、小隐静脉和上肢静脉。临床评估并不充分。静脉造影效果良好，但与双功多普勒相比，它是一种具有一定局限性的侵入性探查。超声探查也不存在其潜在并发症。因此，双功多普勒是首选。血管造影师和外科医生之间的密切协作对于比较术前获得的精确测量值和手术结果至关重要，尤其是关于静脉管径的结果。然后可以确定校正系数。
