Document Detail


Long-term results of in situ saphenous vein bypass. Analysis of 2058 cases.
MedLine Citation:
PMID:  7574925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The authors evaluated the long-term patency and outcome of patients undergoing infrainguinal reconstruction using the in situ saphenous vein. SUMMARY BACKGROUND DATA: The in situ saphenous vein bypass has demonstrated excellent patency and limb salvage rates in numerous studies. The authors previously reported their early results with these bypass procedures, and this article represents their long-term experience with 2058 in situ saphenous vein bypasses during a 20-year period. This comprises the largest series with long-term follow-up of in situ saphenous vein bypasses in the literature. METHODS: From 1975 to 1995, 3148 autogenous vein bypasses were performed at the authors' institution, of which 2058 used the saphenous vein in situ. The indication for operation was limb-threatening ischemia in 1875 of 2058 patients (91%). In 88% of patients with an intact ipsilateral saphenous vein, an in situ bypass was completed successfully. One thousand twenty-three bypasses (69%) were terminated at the infrapopliteal level. Of these bypasses, 1562 of 2058 (76%) were completed using the closed in situ technique. RESULTS: The 30-day patency rate was 96%, and the cumulative secondary patency was 91%, 81%, and 70% at 1, 5, and 10 years, respectively. Limb salvage rates using the in situ bypass were 97%, 95%, and 90% at 1, 5, and 10 years, respectively. CONCLUSION: The infrainguinal inflow source, length of bypass, specific outflow vessel, or vein diameter did not have a significant effect on immediate or long-term bypass performance. These data suggest that the in situ saphenous vein is an excellent conduit for femoropopliteal and femoral to infrageniculate bypasses for limb salvage.
Authors:
D M Shah; R C Darling; B B Chang; K M Fitzgerald; P S Paty; R P Leather
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  222     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-11-22     Completed Date:  1995-11-22     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  438-46; discussion 446-8     Citation Subset:  AIM; IM    
Affiliation:
Albany Medical College, Vascular Surgery Section, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical / methods
Child
Female
Femoral Artery / surgery
Follow-Up Studies
Humans
Ischemia / surgery
Leg / blood supply
Male
Middle Aged
Postoperative Complications
Reoperation
Saphenous Vein / transplantation*
Tibial Arteries / surgery
Vascular Patency
Vascular Surgical Procedures / methods
Comments/Corrections

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