| The effect on patency of type, shape and volume of a vein collar used at the distal anastomis of PTFE-bypass to arteries below-knee. | |
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MedLine Citation:
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PMID: 22801400 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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AIM: The aim of this paper was to study the effect on patency rate of different types of vein collar (Miller's original or St Mary's boot), different length/height shapes of vein collar, and different vein collar volumes at the distal anastomosis of PTFE-bypass grafts to below-knee arteries in patients with critical limb ischemia. METHODS: One hundred eighty patients operated on with PTFE-bypass to below-knee arteries with a vein collar at the distal anastomosis were analyzed. They were recruited from a prospective randomized trial evaluating the effect of adding a vein collar to the distal anastomosis. Primary patency rate of the reconstructions were assessed against three factors: the type, shape, and volume of the vein collar. Univariate analysis was performed with the help of plotted Kaplan-Meier lifetable curves and log-rank tests and multivariate analysis with Cox proportional hazards regression. RESULTS: Type of vein collar had no influence on primary patency (logrank-test, χ2=0.8, df=1, P=0.377, N.=180). A length/height ratio of the vein collar between 1.18 and 1.63 were advantageous for primary patency but the effect was not statistically significant (logrank-test, chisq=5.5, df=2, P=0.063, N.=177). A large volume of the vein collar enhanced primary patency (logrank-test, chisq=6, df=2, P=0.050, N.=173). In the multivariate analysis, however, a larger volume and a length/height ratio between 1.18 and 1.63 as well as > 1.63 reduce the risk of graft failure with 48% (P=0.00006), 58% (P=0.007), 58% (P=0.004), respectively, while vein collar type had no effect on primary patency. CONCLUSION: This prospective observational study indicates that if a vein collar is used at the distal anastomosis of a PTFE-bypass to below-knee arteries it should be long compared to height and large in volume to improve primary patency rate, while the type of vein collar does not appear to matter. |
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Authors:
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F Lundgren |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International angiology : a journal of the International Union of Angiology Volume: 31 ISSN: 1827-1839 ISO Abbreviation: Int Angiol Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-07-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8402693 Medline TA: Int Angiol Country: Italy |
Other Details:
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Languages: eng Pagination: 348-55 Citation Subset: IM |
Affiliation:
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Scandinavian Miller Collar Study (SCAMICOS), Sweden - fredrik.bg.lundgren@gmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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