关键词: 动脉硬化闭塞症；大隐静脉；原位；自体；血管外科手术

Abstract:

Objective   To evaluate the result of in situ great saphenouse vein bypass for the treatment of Fontaine Ⅲ、 Ⅳ arteriosclerosis obliterans of lower limb. Methods   26 patients with Fontaine Ⅲ、 Ⅳ arteriosclerosis obliterans of lower limb were treated with in situ great saphenouse vein bypass by using THE BUSHTM valvulotome.  Results   All cases of postoperative symptoms were alleviated. The rest pain disappeared, skin temperature significantly increased, ulcer healed with clear boundaries between the necrosis and the normal tissue in 25 cases. The rest 1 case was amputated in other hospital because of the postoperative thrombogenesis in the great saphenouse vein.The average ankle/brachial index (ABI) increased from 0.32 to 0.78. The cumulative patency rate at 6, 12 and 24 months was 96.1%, 88.5%, 80.8%, respectively. Conclusion   Application of in situ saphenous vein bypass according to the patients is an effective way to treat Fontaine Ⅲ、Ⅳ arteriosclerosis obliterans, especially those with severe symptoms of ischemia because of long-range, multi-segment, multi-planar stenosis or occlusion.

Key words: Arteriosclerosis obliterans； Great saphenous vein； In situ； Autologous； Vascular surgery