Small Saphenous Vein and Arm Vein as Bypass Grafts for Upper Extremity Ischemia.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 8703941 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1615-5947 (Electronic) Linking ISSN: 08905096 NLM ISO Abbreviation: Ann Vasc Surg Subsets: MEDLINE
    • Publication Information:
      Publication: <2007->: Netherlands : Elsevier
      Original Publication: Detroit : [Published by Expansion scientifique française for Annals of Vascular Surgery, Inc. and Association pour la promotion de la chirurgie vasculaire, Paris, c1986-
    • Subject Terms:
      Ischemia/*surgery ; Saphenous Vein/*transplantation ; Upper Extremity/*blood supply ; Vascular Grafting/*methods; Adult ; Aged ; Female ; Graft Occlusion, Vascular/etiology ; Graft Occlusion, Vascular/physiopathology ; Graft Occlusion, Vascular/therapy ; Humans ; Ischemia/diagnostic imaging ; Ischemia/mortality ; Ischemia/physiopathology ; Limb Salvage ; Male ; Middle Aged ; Retreatment ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Vascular Grafting/adverse effects ; Vascular Grafting/mortality ; Vascular Patency
    • Abstract:
      Background: Bypass in the upper extremity is a rare procedure mainly performed for chronic ischemia, trauma, or hemodialysis access complications. Feasibility and success of use of the arm vein and small saphenous vein (SSV) for autologous vein bypass have been reported in peripheral artery bypass procedures. There are very few reports on the use of alternative veins in upper extremity bypass. We report our experience with arm vein and SSV as a graft source in upper extremity arterial disease.
      Methods: Retrospective analysis of a consecutively collected case series in an academic tertiary referral center from January 2010 to February 2018. Study end points were primary patency, secondary patency, limb salvage, and survival.
      Results: In total, 47 patients were treated with upper extremity bypass either using the SSV (n = 17) or arm veins (n = 30). Indications were either acute (n = 12) or chronic ischemia (n = 35) caused by acute (n = 8) and chronic (n = 9) trauma, sequela of iatrogenic interventions (n = 4), peripheral artery disease (n = 14), thrombangiitis obliterans (n = 3), and dialysis-access-related complications (n = 9). An arm vein was used in 30 and the SSV in 17 patients. Primary patency after 12 months was 87% with the SSV and 75% with an arm vein (P = 0.8) and 63% and 75% after 36 months (P = 0.9). Secondary patency were 100% with an arm vein and 100% with the SSV after 36 months (P = 0.4). One patient had to undergo major amputation and 2 minor amputations.
      Conclusions: Arm vein revascularization using the primarily arm vein or SSV as a bypass conduit can be performed with reasonable mortality and morbidity rates and provide good results comparable with the greater saphenous vein.
      (Copyright © 2019. Published by Elsevier Inc.)
    • Publication Date:
      Date Created: 20190511 Date Completed: 20191223 Latest Revision: 20191223
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.avsg.2019.02.015
    • Accession Number:
      31075469