Endoscopic vein preparation in peripheral bypass surgery
Stierli, P.; Bissat, A.
Helvetica Chirurgica Acta 57(2): 351-354
1990
ISSN/ISBN: 0018-0181 PMID: 2074198 Document Number: 347797
The autogenous saphenous venous bypass is accepted as an optimal procedure for distal arterial reconstruction. For the past ten years the "in situ" technique was developed, and excellent results have now been achieved. The achilles heel of the method is the complete and atraumatic disruption of the valves. We use an angiofiberscope (Olympus PF 22A) with an outer diameter of 2.2 mm, being introduced through the proximal exposed end of the saphenous vein. Through the distal end or a side branch a modified Mill's Valvulotome with a flushing channel is moved upwards to the angioscope. Every valve cusp is incised under direct vision in a retrograde direction. Simultaneously relevant tributaries are angioscopically located and ligated through small skin incisions.