ヤマキ　タカシ   八巻　隆    所属   医学部 医学科（附属足立医療センター）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Preliminary report of a new approach to sparing the greater saphenous vein for grafting: valvuloplasty combined with axial transposition of a competent tributary vein.
掲載誌名	正式名：Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 略　 称：J Endovasc Ther ISSNコード：1526-6028(Print)1526-6028(Linking)
巻・号・頁	8(2),pp.188-96
著者・共著者	Yamaki T, Nozaki M, Sasaki K
担当区分	筆頭著者
発行年月	2001/04
概要	PURPOSE:To compare a new vessel-sparing technique combining valvuloplasty with axial transposition of a competent tributary vein versus single valvuloplasty for the treatment of greater saphenous vein (GSV) incompetence.METHODS:In 55 patients with GSV incompetence, 29 of 57 limbs were treated by angioscopic valvuloplasty of the subterminal valve alone, whereas the remaining 28 limbs underwent angioscopic valvuloplasty combined with axial transposition of a competent tributary vein identified preoperatively by duplex scanning. After angioscopic valvuloplasty in the latter group, the competent tributary vein was exposed and cut 1.5 cm distal to its insertion point on the GSV. The transected vein was anastomosed end to side to the GSV, which was ligated between the tributary insertion site and the anastomosis. Changes in venous hemodynamics, including venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF), were analyzed by use of air plethysmography.RESULTS:In the 1-year follow-up, no venous thrombosis was detected in either group. In the valvuloplasty-only group, 22 (75.9%) limbs exhibited reflux in the proximal GSV; recurrent varicose veins were detected in 5 (17.2%) limbs. In contrast, only 2 (7.1%) limbs showed reflux in the valvuloplasty + transposition group. There were no significant differences in EF and RVF between the groups before or after the operation, although a significant difference was seen in VFI at 1 year (p = 0.005, Wilcoxon rank sum test).CONCLUSIONS:Valvuloplasty combined with tributary vein transposition gives a better result than valvuloplasty alone at 1 year. This new treatment option may be useful for both reducing the rate of varicose veins and sparing the GSV for grafting.
DOI	2.0.CO;2
文献番号	11357981