Document Detail


Arm vein as a last autogenous option for infrainguinal bypass surgery: it is worth the effort.
MedLine Citation:
PMID:  17293130     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Considerable evidence exists for the use of arm vein conduit in lower limb bypass surgery. The use of arm vein in preference to synthetic conduit as a last autogenous option was assessed for patency and limb salvage outcomes. MATERIALS AND METHODS: A prospective database was interrogated and checked against TQEH operating theatre database to detect all infrainguinal arm vein bypasses performed between 1997 and 2005. Patency, limb salvage and survival data for 37 arm vein bypasses was calculated using the Kaplan-Meier survival estimate method. RESULTS: There were no perioperative deaths. 30 day patency rates were 89% primary, 95% secondary and 95% limb salvage. 12 month patency rates were 56% primary, 79% secondary and 91% limb salvage. 5 year patency rates were 37% primary, 76% secondary and 91% limb salvage. There was no significant patency advantage for primary vs. "redo" grafts (p=0.54), single vessel vs. spliced conduits (p=0.33) or popliteal vs tibial outflow (p=0.80). Patient survival rate was 92% and 65% at 1 and 5 years respectively. CONCLUSION: Lower limb bypasses using arm vein can be performed with favourable patency and limb salvage compared to synthetic conduits. However, secondary interventions are frequently required to maintain patency. We recommend a vigilant surveillance program for early identification of patency threatening disease.
Authors:
R L Varcoe; W Chee; P Subramaniam; D M Roach; G L Benveniste; R A Fitridge
Publication Detail:
Type:  Journal Article     Date:  2007-02-12
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  33     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-07     Completed Date:  2007-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  737-41     Citation Subset:  IM    
Affiliation:
Department of Surgery, The Queen Elizabeth Hospital, Woodville, Australia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography, Digital Subtraction
Arm / blood supply*
Arterial Occlusive Diseases / diagnosis,  physiopathology,  surgery*
Arteriovenous Shunt, Surgical / methods*
Female
Femoral Artery*
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies
Transplantation, Autologous
Treatment Outcome
Ultrasonography, Doppler, Duplex
Vascular Patency
Veins / transplantation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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