Document Detail

Femoral-distal bypass with in situ greater saphenous vein. Long-term results using the Mills valvulotome.
MedLine Citation:
PMID:  2025066     Owner:  NLM     Status:  MEDLINE    
During a 7-year period, 440 consecutive in situ saphenous vein grafts originating in the groin were performed in 371 patients, exposing the entire vein for valvulotomy with a modified Mills valvulotome. critical ischemia was the indication for bypass in 68%, and the distal anastomosis was to an infrapopliteal artery in 46%. Thirty-day operative mortality was 2.0%. Postoperative surveillance identified 18 stenotic grafts (4.1%), which were revised while still patent (primary revised patency); 36 grafts (8.2%) underwent revision after graft occlusion (secondary patency). Five-year life-table analysis showed overall primary revised patency of 78%, secondary patency of 83%, limb salvage of 88%, and patient survival of 66%. Femoroperoneal and inframalleolar bypasses fared well. The presence of diabetes did not diminish late graft patency. In contrast to reversed vein grafts, long infrapopliteal in situ grafts had long-term secondary patency similar to shorter femoropopliteal bypass grafts (p greater than 0.05). These results, coupled with the versatility and simplicity of the technique as used in the present series, suggest that in situ vein grafting is the procedure of choice for long infrapopliteal bypass.
M C Donaldson; J A Mannick; A D Whittemore
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of surgery     Volume:  213     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-05-31     Completed Date:  1991-05-31     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  457-64; discussion 464-5     Citation Subset:  AIM; IM    
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
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MeSH Terms
Aged, 80 and over
Arterial Occlusive Diseases / surgery*
Femoral Artery / surgery*
Follow-Up Studies
Graft Occlusion, Vascular / etiology
Leg / blood supply
Middle Aged
Popliteal Artery / surgery
Postoperative Complications / etiology
Saphenous Vein / surgery*,  transplantation
Vascular Patency
Vascular Surgical Procedures / methods

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

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