Arm Vein versus Small Saphenous Vein for Lower Extremity Bypass in the Absence of Both Great Saphenous Veins
| Autor: | Peter Metzger, Werner Dabernig, Wolfgang Hitzl, Patrick Nierlich, Fatema Akhavan, Florian K. Enzmann, Thomas Hölzenbein, Julio Ellacuriaga San Martin |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment 030204 cardiovascular system & hematology Amputation Surgical 030218 nuclear medicine & medical imaging 03 medical and health sciences Small saphenous vein Peripheral Arterial Disease 0302 clinical medicine Risk Factors Vascular Patency Medicine Humans Saphenous Vein Vein Aged Retrospective Studies Aged 80 and over business.industry Great saphenous vein Retrospective cohort study General Medicine Middle Aged Limb Salvage Peripheral Surgery medicine.anatomical_structure Treatment Outcome Bypass surgery Amputation Arm Female Vascular Grafting Cardiology and Cardiovascular Medicine business |
| Zdroj: | Annals of vascular surgery. 70 |
| ISSN: | 1615-5947 |
| Popis: | Background Bypass surgery remains the gold standard for long and complex arterial occlusions in the lower limb. The vein is regarded superior to prosthetic conduits in peripheral arterial bypass surgery. However, this option is often limited because of previous bypass, stripping, or poor quality of the ipsilateral and/or contralateral great saphenous vein (GSV). Under these circumstances, the arm vein (AV) and small saphenous vein (SSV) are the only alternative autologous vein grafts. Methods We analyzed all consecutive patients treated at an academic tertiary referral center between January 1998 and July 2018 using either the AV or SSV as the main peripheral bypass graft. Study end points were primary patency, secondary patency, limb salvage, and survival. Results In total, 416 bypass procedures using exclusively AV (n = 327) or SSV (n = 89) were performed. There was a predominance of male gender. The majority of risk factors were evenly distributed between groups. The mean follow-up period was 2.3 years (0.9 to 13.3 years). Five-year primary and secondary patency rates were 39% (95% CI: 31–47%) and 67% (59–75%) for AV and 53% (41–66%) and 76% (67–86%) for SSV, respectively (P = 0.2 and 0.25). The five-year limb salvage and survival rates were 71% (68–81%) and 84% (77–90%) for AV and 78% (67–88%) and 90% (82–98%) for SSV, respectively (P = 0.52 and 0.11). Conclusions Both AV and SSV are equally effective alternatives for peripheral bypass if no GSV is available. Although there was a trend toward better results with the SSV, there was no significant difference between the 2 options. |
| Databáze: | OpenAIRE |
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