血管镜直视下股浅静脉壁外瓣膜修复成形术

Surgical Technique of Superfacial Femoral Vein Valvuloplasty Under Direct Angioscopic Vision without Venotomy

作者首次设计并实行了血管镜直视下股浅静脉壁外瓣膜修复成形术。该手术的适应证主要为瓣膜先天发育完善,但受致病因素作用瓣叶发生皱褶脱垂,瓣叶间出现不规则裂隙,瓣环存在不同程度的扩张。该手术主要针对股浅静脉第一对瓣膜功能不全而设计,但也可尝试应用于腘静脉瓣膜的修复成形,并可应用于多对瓣膜的修复。此手术的优点主要有:(1)血管镜可以确诊瓣膜功能不全的程度,为瓣膜修复成形术提供可靠的依据;(2)此手术避免了切开静脉壁和暴露瓣膜,减少了术后血栓形成的机率。(3)本手术克服了 Kistner 静脉壁外瓣膜修复成形术的盲目性,变经验性非直视术为直视性修复成形术。准确掌握瓣膜修复程度。

Using angioscopy,we made the Superfacial Femoral Vein(SFV) Valvuloplasty under direct angio- scopic vision without venotomy,which is indicated for primary SFV valve incompetence and the primary popliteal vein valve insufficiency,for valves developed completely inborn,but with the effects of postnatal pathogenic factors,the leaflets elongated,creased,pro- lapsed and became redundant;irregular diastema between leaflets emerged and the valve ring dilated.Angioscopy can confirm primary venous valve incompetence and di- rectly inspect pathologic characteristics of the valves.The technique without venotomy and valve exposure,de- creased the rate of postoperative venous thrombosis.The operation eliminates the blindness of Kistner's external surgical technique,overcoming its empiricism.The pre- liminary clinical use of the technique has shown excellent short-term effect without complications.