血管镜直视下腘静脉壁外多瓣膜修复成形术

利用血管镜纤细柔顺和立体直视的先进性能,作者成功设计和施行了血管镜直视下腘静脉壁外多瓣膜修复成形术.经24例30条下肢76对瓣膜手术的初步临床应用,证明该手术具有如下优点:(1)血管镜不仅可以直视诊断瓣膜病变,直视监控手术操作,还可即时直视评估手术效果.(2)在血管镜直视下一次手术可同时修复多对瓣膜,以多瓣膜完善的整合力量替代单瓣膜的薄弱屏障,极大地提高了阻抗逆向静脉血柱压力的效能.(3)无论在发病学、诊断学还是治疗学上,腘静脉瓣膜对原发性深静脉瓣膜功能不全均具有最直接的影响,因此.着眼于静脉的瓣膜修复成形术优于股静脉瓣膜修复成形术.(4)多瓣膜修复成形术在不切开静脉壁条件下完成,避免了瓣膜损伤和手术后血栓形成的并发症.作者期望这一新设计术式能在逐步推广应用中得到验证.

Multiple and External Valvuloplasty of Popliteal Vein Under Direct Angioscopic Vision

With the excellent property of gracile comliance and direct vision of angioscopy, we suc-cessfully designed and performed the multiple and ex-ternal valvuloplasty (MEV) of popliteal vein under direct angioscopic vision. The initial experience of 76 valvuloplsties in 30 lower extremities of 24 patients with primary venous insufficiency (PVI) veriftes that MEV has following merits. (1) Angioscopy can not only give a diagnosis of PVI under direct vision, su-pervise operation procedures visualty, bat also evalu-ate the operative effect immediately. (2)Multiple valves are repaired at one time, which integrates the multiple repaired valves as an entirety to correct the PVI more effectively. (3) In etiopathology, diagnosis and treatment, valves in popliteal vein have the most direct influence on PVI, the MEV focuxing on popliteal vein has better effect then. (4) MEV is car-ried out without venotomy, which avoids injury of valves and postoperative venous thrombosis. The au-thor expects that the newly-designed MEV procedure would be verified by other authors' experience and long-term results.