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首页> 外文期刊>Vascular surgery >The case for an in situ lesser saphenous vein bypass.
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The case for an in situ lesser saphenous vein bypass.

机译：原位小隐静脉旁路手术的情况。

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In situ lesser saphenous vein (LSV) graft has been advocated in cases where the greater saphenous vein is not available and the target arteries are confined to the lower leg. This is often the case of diabetic patients, whose occlusive disease pattern typically affects the tibioperoneal vessels, sparing the femoropopliteal segment. The in situ technique offers the potential advantages of decreasing surgical trauma to the vein and its vasa vasorum, better size-matching between vein and artery at the anastomoses, and improving hemodynamics. The authors reviewed the use of in situ LSV graft with attention to its indications and technical requirements. A 73- and a 76-year-old man presented with critical limb ischemia. Both had a history of diabetes, chronic renal failure, and previous use of the greater saphenous veins for coronary or peripheral bypasses. Both had good femoropopliteal inflow and tibioperoneal disease with single runoff through the distal peroneal and common plantar arteries, respectively. Venous mapping showed diminutive veins, with exception of an adequate ipsilateral lesser saphenous vein. The patients were placed in prone position for a posterior approach. The lesser saphenous veins were exposed through a longitudinal incision. Proximal anastomosis was based on the popliteal artery, exposed through the same incision. A successful in situ lesser saphenous vein bypass was performed by using the common plantar and the distal peroneal artery as target vessels. Both bypasses were patent at 24 and 18-months' follow-up, respectively. Selection criteria for in situ LSV bypass are patent femoral arteries; accessible target vessels in prone position through a medial, posterior, or lateral approach; and adequate LSV in diameter and length. In the authors' experience, in situ LSV bypass is a safe and simple option that offers successful distal revascularization.
机译：在无法获得大隐静脉且目标动脉局限于小腿的情况下，提倡就地隐匿小隐静脉（LSV）。糖尿病患者通常是这种情况，其闭塞性疾病模式通常会影响胫腓骨血管，而保留股pop段。原位技术具有以下潜在优势：减少对静脉及其血管脉的手术创伤，在吻合处更好地实现静脉和动脉之间的尺寸匹配，并改善血液动力学。作者回顾了原位LSV移植的使用，并注意其适应症和技术要求。一名73岁和76岁的男子出现严重肢体缺血。两者都有糖尿病史，慢性肾功能衰竭以及以前使用大隐静脉进行冠状动脉或外周旁路手术的历史。两者均具有良好的股pop骨流入和胫腓骨疾病，并分别通过腓骨远端和普通plant动脉形成单个径流。静脉标测显示静脉缩小，但同侧小隐静脉适当。将患者俯卧以进行后路入路。小隐静脉通过纵向切口暴露。近端吻合是基于artery动脉，通过同一切口暴露。使用足底和腓总动脉作为目标血管，成功地进行了小隐隐静脉旁路手术。两种旁路均分别在随访的24个月和18个月获得了专利。原位LSV旁路的选择标准是股动脉。通过内侧，后侧或外侧入路可俯卧的目标血管;并在直径和长度上具有足够的LSV。根据作者的经验，原位LSV旁路术是一种安全，简单的选择，可提供成功的远端血运重建。

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