Document Detail


Stenosis of reverse great saphenous vein graft in infrainguinal arterial revascularization.
MedLine Citation:
PMID:  21537706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to evaluate the prevalence of hemodynamically significant infrainguinal bypasses stenosis using reverse great saphenous vein graft.
METHODS: From March of 2008 to March of 2009, 56 infrainguinal bypasses were performed with reverse great saphenous vein graft in 56 patients. On the 30th post-operative day, 32 out of 56 patients were submitted to vascular ultrasonography. The prevalence of significant graft stenosis was determined. In addition, the diagnosis of stenosis was related to the clinical and surgical characteristics of the patients. The variables analyzed at the moment of diagnosis were the localization of the graft stenosis, the risk factors associated with stenosis and the association of vascular ultrasonography findings with ankle brachial pressure index (ABI).
RESULTS: The overall prevalence of significant graft stenosis was 48.4%. Out of the total number of observed stenosis, 19.4% were considered severe, and 29% mild or moderate. There was no significant association between the presence of significant stenosis and the following variables: gender, diabetes, hypertension, smoking, hipercholesterolemia, graft diameter, site of the distal anastomosis, and graft composition. There was a weak agreement between ABI and vascular ultrasonography in detecting stenosis in general (K = 0.30; CL95% 0.232 - 0.473; p = 0.018). However, there was a substantial agreement in detecting severe stenosis (K = 0.75; CL95% 0.655 - 0.811; p = 0.0001).
CONCLUSION: There was a high prevalence of stenosis on the 30th post-operative day, mostly localized in the proximal half of the vein graft. There was no significant association of stenosis with clinical and surgical factors analyzed. ABI and vascular ultrasonography had weak agreement with the diagnosis of stenosis in general and an important agreement for the diagnosis of severe stenosis.
Authors:
Francesco Evangelista Botelho; Tarcizo Afonso Nunes; Túlio Pinho Navarro; Bruno Lima de Castro; Daniel Lopes Pinheiro; Jose Oyama Moura Leite; Petronio Generoso Thomaz; Renato Samy Assad
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Revista da Associação Médica Brasileira (1992)     Volume:  57     ISSN:  0104-4230     ISO Abbreviation:  Rev Assoc Med Bras     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-05-03     Completed Date:  2012-01-26     Revised Date:  2012-04-11    
Medline Journal Info:
Nlm Unique ID:  9308586     Medline TA:  Rev Assoc Med Bras     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  187-93     Citation Subset:  IM    
Affiliation:
Universidade Federal de Minas Gerais – UFMG, Belo Horizonte, MG, Brazil. petronio@sbccv.org.br
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MeSH Terms
Descriptor/Qualifier:
Ankle Brachial Index
Arteries
Constriction, Pathologic / epidemiology,  etiology*,  ultrasonography
Female
Graft Occlusion, Vascular / epidemiology*,  etiology,  ultrasonography
Humans
Male
Prevalence
Risk Factors
Saphenous Vein / transplantation*,  ultrasonography
Ultrasonography, Doppler, Duplex

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