Document Detail

Late occlusion of microvascular vein grafts in replantation.
MedLine Citation:
PMID:  9848567     Owner:  NLM     Status:  MEDLINE    
Two cases are described in which patients presented 16 and 17 years, respectively, after complete or incomplete amputation/replantation of the arm. In case 1, the patient complained of coldness, pain, and tingling in the replanted arm in the previous 24 hours and noticed that his fingers had gone white. Arteriography and subsequent surgery revealed obliteration of the vein graft (inserted in the distal brachial artery) by neointimal thickening and atherosclerotic plaque, which was confirmed in a subsequent morphologic examination. In case 2, the patient presented with discomfort and a pulsatile swelling on the inner aspect of his upper arm. Arteriography and surgery revealed an aneurysm in the previously inserted vein graft in the brachial artery, with some atherosclerotic degeneration. Both vein grafts were successfully replaced with a fresh autologous vein graft and the patients remain well several years later. The 2 cases suggest that as part of replantation surgery of a limb, it is essential to maintain postoperative clinical monitoring for signs of graft degeneration in all patients with long-term vein graft insertion.
W A Morrison; G M Mitchell; M J Hickey
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  23     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-03-09     Completed Date:  1999-03-09     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1106-11     Citation Subset:  IM    
Department of Surgery, University of Melbourne, St Vincent's Hospital, Fitzroy, Victoria, Australia.
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MeSH Terms
Amputation, Traumatic*
Forearm / blood supply*,  surgery*
Graft Occlusion, Vascular / pathology*
Off-Road Motor Vehicles
Saphenous Vein / transplantation*

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

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