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@article{2413666,
author = {Biroš, Ernest and Staffa, Robert and Krejčí, Miroslav and Novotný, Tomáš and Skotakova, Monika and Bobák, Róbert},
article_location = {NEW YORK},
article_number = {June 2024},
doi = {http://dx.doi.org/10.1016/j.avsg.2023.12.067},
keywords = {Vein Grafts; Infrainguinal Bypass},
language = {eng},
issn = {0890-5096},
journal = {Annals of Vascular Surgery},
title = {Autologous Alternative Vein Grafts for Infrainguinal Bypass in the Absence of Single-Segment Great Saphenous Vein: A Single-Center Study},
url = {https://www.sciencedirect.com/science/article/abs/pii/S0890509624000529?via%3Dihub},
volume = {103},
year = {2024}
}
TY - JOUR
ID - 2413666
AU - Biroš, Ernest - Staffa, Robert - Krejčí, Miroslav - Novotný, Tomáš - Skotakova, Monika - Bobák, Róbert
PY - 2024
TI - Autologous Alternative Vein Grafts for Infrainguinal Bypass in the Absence of Single-Segment Great Saphenous Vein: A Single-Center Study
JF - Annals of Vascular Surgery
VL - 103
IS - June 2024
SP - 133-140
EP - 133-140
PB - ELSEVIER SCIENCE INC
SN - 08905096
KW - Vein Grafts
KW - Infrainguinal Bypass
UR - https://www.sciencedirect.com/science/article/abs/pii/S0890509624000529?via%3Dihub
N2 - Background: Alternative autologous veins can be used as a conduit when adequate great saphenous vein is unavailable. We analyzed the results of our infrainguinal bypasses after adopting upper extremity veins in our practice. Methods: This is a single-center observational study involving all patients whose infrainguinal bypass involved the use of upper extremity veins between April 2019, when we began using arm veins, and February 2023. Results: During the study period, 49 bypasses were done in 48 patients; mean age 68.1 +/- 9.8; men 32 (66.7%); body mass index 28.0 +/- 4.8; indications for surgery: chronic limb threatening ischemia 41 (83.7%); acute limb ischemia 3 (6.1%); complications of previous prosthetic 3 (6.1%), or autologous 2 (4.1%) bypass grafts. Vein splicing was used in 43 (87.8%) bypasses with 3-segment grafts being the most common (26; 53.1%). There were 24 (49.0%) femorotibial, 11 (22.4%) femoropopliteal, 9 (18.4%) femoropedal, and 5 (10.2%) extension jump bypass procedures. Eighteen (36.7%) operations were redo surgeries. Twenty-one (42.9%) bypasses were formed using only arm veins. The median follow-up was 12.9 months (4.5e24.2). Two bypasses occluded during the first 30 postoperative days (2/49; 4.1%). Overall 30-day, 1-year, and 2-year primary patency rates were 93.7% +/- 3.5%, 84.8% +/- 5.9%, and 80.6% +/- 6.9%, and secondary patency (SP) rates were 95.8% +/- 2.9%, 89.2% +/- 5.3%, and 89.2% +/- 5.3%. One-segment grafts had better patencies than 2-, 3-, and 4-segment grafts (1-year SP 100% +/- 0% vs 87.6% +/- 6.0%). Two-year amputation-free survival was 86.8% +/- 6.5%; 2-year overall survival was 88.2% +/- 6.6%. Conclusions: Integration of arm vein grafts in infrainguinal bypass practice can be done safely with low incidences of perioperative graft failure. One-segment grafts had better patencies than spliced vein grafts. The achieved early patency and amputation-free survival rates strongly encourage their use. In the absence of a single -segment great saphenous vein, upper extremity vein grafts should be the preferred conduit choice.
ER -
BIROŠ, Ernest, Robert STAFFA, Miroslav KREJČÍ, Tomáš NOVOTNÝ, Monika SKOTAKOVA a Róbert BOBÁK. Autologous Alternative Vein Grafts for Infrainguinal Bypass in the Absence of Single-Segment Great Saphenous Vein: A Single-Center Study. \textit{Annals of Vascular Surgery}. NEW YORK: ELSEVIER SCIENCE INC, 2024, roč.~103, June 2024, s.~133-140. ISSN~0890-5096. Dostupné z: https://dx.doi.org/10.1016/j.avsg.2023.12.067.
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