Jing Z, Cao G, Zhong J
Division of Vascular Surgery, Changhai Hospital.
Zhonghua Wai Ke Za Zhi. 1996 Jul;34(7):391-3.
The authors' initial experience of angioscopic in-situ arterial bypass of 37 extremities reveals that angioscopy can be used to assist complete valvular ablation and precise location and ligation of tributaries of saphenous vein grafts, avoiding postoperative arterial-venous fistula and warm ischemic injury to grafts. Angioscopy is also used to perform intraoperative completion inspection of the grafts and anastomoses. The designed biocomposite graft and common ostium technique promotes the usage rate of the limited autogenous vein grafts and enlarges the diameter of grafts and blood flow through the distal anastomosis. Because of the above new series of procedures, the extremity salvage rate in this study was 34/37 limbs. During the follow-up period of 2-18 months, all anastomoses were patent. The preoperative ankle and toe pressure of 3.5 +/- 0.2 kPa and 2.0 +/- 0.1 kPa respectively rose to 5.4 +/- 0.1 kPa and 3.8 +/- 0.2 kPa postoperatively. We conclude that angioscopic in-situ arterial bypass surgery is of practical value and specially advantageous in lower extremity revascularization.
作者对37条肢体进行血管镜原位动脉搭桥的初步经验表明，血管镜可用于辅助完成瓣膜消融以及精确定位和结扎大隐静脉移植物的分支，避免术后动静脉瘘和移植物的热缺血损伤。血管镜还用于对移植物和吻合口进行术中完整性检查。所设计的生物复合移植物和共同开口技术提高了有限自体静脉移植物的使用率，并扩大了移植物直径以及通过远端吻合口的血流量。由于上述一系列新手术，本研究中肢体挽救率为34/37例。在2至18个月的随访期内，所有吻合口均通畅。术前踝部和趾部压力分别为3.5±0.2kPa和2.0±0.1kPa，术后分别升至5.4±0.1kPa和3.8±0.2kPa。我们得出结论，血管镜原位动脉搭桥手术具有实用价值，在下肢血管重建中特别有利。
