Document Detail


Prospective comparison of arm veins and greater saphenous veins as infrageniculate bypass grafts.
MedLine Citation:
PMID:  11472048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: to compare arm and saphenous veins for infrageniculate bypass grafting. DESIGN: prospective non-randomised study. MATERIALS: two hundred patients, of which 197 had ischaemic tissue loss or rest pain. METHODS: two hundred and eleven infrageniculate vein bypass procedures using 176 greater saphenous veins and 35 arm veins. RESULTS: the cumulative primary graft patency rate at 1-month and 2 years was 80% and 61% for saphenous vein and 89% and 42% for arm vein. The corresponding rates for secondary patency were 84.5% and 68%, and 91% and 57%, respectively. These results corresponded to a relative risk of secondary failure of 1.53 (95% CI 0.71, 3.31) for arm vein grafts. In subgroup analyses, this estimate was 0.93 and 2.1 for primary vs secondary bypasses and 0.38 and 2.06 for single-vein vs spliced-vein bypasses. Among arm veins, cephalic vein grafts performed better than basilic vein grafts. Early mortality was 14% for arm vein and 10% for saphenous vein. CONCLUSION: in the setting of infrageniculate bypass grafting, arm vein grafts are not equivalent to greater saphenous vein grafts, but contribute importantly to a policy of using autologous veins. The possibility of equivalence remains for the arm vein graft that uses a cephalic vein or is a primary procedure.
Authors:
F C Brochado-Neto; M Albers; C A Pereira; J Gonzalez; M Cinelli
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  22     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-07-26     Completed Date:  2001-08-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  146-51     Citation Subset:  IM    
Copyright Information:
Copyright 2001 Harcourt Publishers Limited.
Affiliation:
Serviço de Cirurgia Vascular, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, Brasil.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Follow-Up Studies
Graft Occlusion, Vascular / etiology*,  mortality
Humans
Intermittent Claudication / mortality,  surgery*
Ischemia / mortality,  surgery*
Leg / blood supply*
Male
Middle Aged
Prospective Studies
Risk
Survival Rate
Transplantation, Autologous
Veins / transplantation*

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