Document Detail


Non-greater saphenous vein grafting for infrageniculate bypass.
MedLine Citation:
PMID:  12132743     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infrainguinal bypass grafting with greater saphenous vein has proven to be a highly effective procedure with primary 5-year patency and limb salvage rates exceeding 80 per cent. However, because of prior usage or intrinsic venous disease the greater saphenous vein is often not available as a conduit. Numerous studies have shown that patency rates for prosthetic bypass grafting to the infrageniculate vessels are clearly inferior to that reported for greater saphenous vein bypass. In this report we summarize our experience with the use of alternate autogenous vein grafting to the infrageniculate vessels. The records of all patients undergoing autogenous bypass grafting to the infrageniculate vessels using a conduit other than the greater saphenous vein between 1992 and 1999 were reviewed. Graft survival curves were plotted using the Kaplan-Meier method and results are reported using the Society for Vascular Surgery/International Society for Cardiovascular Surgery guidelines. Forty-eight patients underwent a total of 51 infrageniculate bypass procedures using non-greater saphenous autogenous conduits. Thirty-nine patients had reconstructions performed with single segments of arm vein, two had their operations performed with lesser saphenous vein, and ten had grafts created with two segments of non-greater saphenous autogenous vein. Twenty-one grafts were performed to the infrageniculate popliteal artery and 30 were performed to the tibial vessels. Primary and primary assisted patency rates at 30 months were 49 and 75 per cent. Limb salvage was 87 per cent. Infrainguinal bypass grafting using non-greater saphenous autogenous conduits can yield quite satisfactory intermediate limb salvage and patency rates. However, close graft surveillance and prompt intervention are required to avoid graft failure.
Authors:
Jason Alexander; Charles Gutierrez; Steven Katz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  68     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-22     Completed Date:  2002-07-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  611-4     Citation Subset:  IM    
Affiliation:
Huntington Memorial Hospital and Division of Vascular Surgery, Keck School of Medicine, Pasadena, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Graft Survival
Humans
Leg / blood supply*,  surgery*
Limb Salvage / methods*
Male
Middle Aged
Peripheral Vascular Diseases / surgery*
Transplantation, Autologous
Vascular Patency
Veins / transplantation

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


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