Autologous Alternative Vein Grafts for Infrainguinal Bypass in
the Absence of Single-Segment Great Saphenous Vein: A
Single-Center Study

J 2024

Autologous Alternative Vein Grafts for Infrainguinal Bypass in the Absence of Single-Segment Great Saphenous Vein: A Single-Center Study

BIROŠ, Ernest, Robert STAFFA, Miroslav KREJČÍ, Tomáš NOVOTNÝ, Monika SKOTAKOVA et. al.

Basic information

Original name

Autologous Alternative Vein Grafts for Infrainguinal Bypass in the Absence of Single-Segment Great Saphenous Vein: A Single-Center Study

Authors

BIROŠ, Ernest (703 Slovakia, belonging to the institution), Robert STAFFA (203 Czech Republic, belonging to the institution), Miroslav KREJČÍ (203 Czech Republic, belonging to the institution), Tomáš NOVOTNÝ (203 Czech Republic, belonging to the institution), Monika SKOTAKOVA (203 Czech Republic) and Róbert BOBÁK (703 Slovakia, belonging to the institution)

Edition

Annals of Vascular Surgery, NEW YORK, ELSEVIER SCIENCE INC, 2024, 0890-5096

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 1.500 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.avsg.2023.12.067

UT WoS

001217754800001

Keywords in English

Vein Grafts; Infrainguinal Bypass

Abstract

V originále

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.

Citovat

BIROŠ, Ernest, Robert STAFFA, Miroslav KREJČÍ, Tomáš NOVOTNÝ, Monika SKOTAKOVA and Róbert BOBÁK. Autologous Alternative Vein Grafts for Infrainguinal Bypass in the Absence of Single-Segment Great Saphenous Vein: A Single-Center Study. Annals of Vascular Surgery. NEW YORK: ELSEVIER SCIENCE INC, 2024, vol. 103, June 2024, p. 133-140. ISSN 0890-5096. Available from: https://dx.doi.org/10.1016/j.avsg.2023.12.067.

@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 and 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, vol.~103, June 2024, p.~133-140. ISSN~0890-5096. Available from: https://dx.doi.org/10.1016/j.avsg.2023.12.067.

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