Prejudices and realities in the use of ‘unsuitable’ saphenous vein graft for infrapopliteal revascularization

Siani, Andrea and Accrocca, Federico and Antonelli, Roberto and Giordano, Alessandro G. and Gabrielli, R. and Siani, L.M. and Baldassarre, E. and Mounyergi, F. and Marcucci, Giustino (2008) Prejudices and realities in the use of ‘unsuitable’ saphenous vein graft for infrapopliteal revascularization. Il giornale di chirurgia, 29 (6/7). pp. 261-264. ISSN 1971-145X

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Abstract

Background. Aim of this paper is to evaluate the safety and the patency rate of the infrapopliteal bypass grafts performed with the great saphenous vein (GSV) with small (<2.5 mm) or large calibre (>5 mm). Patients and methods. Between January 2003 and May 2007, 73 infragenicular bypass with autologus saphenous vein were performed in patients affected by atherosclerotic femoropopliteal disease. In 8 cases a bypass grafts with small saphenous vein (diameter 2.2-2.5 mm) were performed, in 4 cases a bypass with segmental varicose saphenous vein (diameter 5.7-6.4 mm ) were carried out. In 64 cases the bypass was carried out with the reversed technique, in 9 cases with the in situ technique. Results. Thirty day mortality was 3/82 (3.6%) and 30 day cumulative patency rate was 95.1% (78/82) with limb salvage of 96.3% (79/82). All the patients with small diameter vein showed a normal patency at the follow-up and at the duplex scan examination no complications occurred. The mean calibre of the arterialized vein increased to 2.6-3,4 mm at 1 week with maintenance during the follow-up. Patients with varicose vein implanted present a mean dilatation of 6.4-7. 2 mm at 1 week and no dilatative complication were detected at the follow-up. Conclusion. The risk of stenosis, graft thrombosis or aneurismal degeneration doesn’t seem to be higher respect normal GSV either for small or for large veins. Large series and longer follow up are mandatory for an extensive clinical application.

Item Type:	Article
Uncontrolled Keywords:	Limb ischemia, varicose veins, surgery
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	24 Jun 2013 12:28
Last Modified:	24 Jun 2013 12:28
URI:	http://eprints.bice.rm.cnr.it/id/eprint/5089

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