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Updated: Jun 26, 2026

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内镜静脉收获与下内绕道更糟但更好的结果有关

Mohamad Chahrour¹, Hassan Chamseddine², Alexander Shepard²

¹Division of Vascular Surgery, Department of Surgery, Iowa Hospitals and Clinics, Iowa City, IA; Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI.

Journal of vascular surgery

|January 1, 2025

概括

开放静脉摘取 (OVH) 为下内绕道手术提供了更好的长期结果,包括较高的移植通透率和肢体挽救率,与内镜静脉摘取 (EVH) 相比. 随着时间的推移,EVH的透度有所改善,但仍然落后于OVH.

科学领域:

血管外科血管外科
手术技巧手术技巧
研究成果研究成果研究成果

背景情况:

对于下内绕道的最佳大静脉收获技术仍在争论中.
缺乏可靠的证据来比较开放静脉采摘 (OVH) 和内镜静脉采摘 (EVH).

研究的目的:

为了比较OVH与EVH的长期结果,在接受下外围手术的患者中.
评估收获技术对初级通透性,辅助通透性,二次通透性,再干预,截肢和主要不良肢体事件的影响.

主要方法:

来自血管质量倡议 (2011-2023) 的7929名OVH和2643名EVH患者的回顾性分析.
倾向性得分匹配被用来平衡群体之间的共变量.
卡普兰-梅尔和考克斯回归分析评估了长期事件率.

主要成果:

EVH显示手术部位感染率较低 (1.8%与2.9%相比).
OVH表现出优异的1年结果:较高的初级通透率 (71%vs65%),初级辅助通透率 (86%vs81%),二次通透率 (90%vs85%) 和较低的截肢率 (6%vs9%),再干预率 (20%vs25%) 和MALE率 (25%vs30%).
从2011年到2020年,EVH的初级通透率显著改善,缩小了与OVH的差距.

结论:

OVH提供优越的长期通透性,再干预和四肢救援结果,用于下内绕道.
EVH与较少的伤口并发症有关,但从历史上看,长期的移植性能较差.
EVH显示透度逐渐改善,随着时间的推移减少了结果差异.

关键词:

内镜静脉收获 (endoscopic vein harvest) 是一种用于检查静脉的方法.大石静脉的大石静脉在下内绕道.打开静脉收获的收获方法在VQI中,VQI是VQI.

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