title: The value of duplex scanning with venous occlusion in the preoperative prediction of femoro-distal vein bypass graft diameter.
abstract: The diameter of the long saphenous vein has been shown to affect the outcome of femoro-distal bypass. Many surgeons regard a vein with a diameter of less than 3 mm as being unsuitable. The long saphenous vein was studied in 35 patients undergoing femoro-distal bypass. Diameter measurements of the vein were performed using an ATL duplex scanner at the groin, mid-thigh and knee. Measurements were performed preoperatively both at rest and with a venous occlusion cuff to dilate the vein, and subsequently at 7 days and 2 months after implantation. The mean diameter of the vein at the mid-thigh was 4.1 mm non-dilated, 5.1 mm with occlusion, 5.0 mm 7 days postoperatively and 5.2 mm at 2 months (ANOVA, p less than 0.05). The mean diameter of the vein at the knee was 3.9 mm non-dilated, 4.8 mm with occlusion, 4.8 mm at 7 days and 4.9 mm at 2 months after operation (ANOVA, p less than 0.025). In all five patients whose preoperative resting vein diameter at the knee or mid-thigh was less than 3 mm, preoperative dilatation occurred, such that the diameter became greater than 3 mm. These results suggest that by using a technique of venous occlusion at the time of pre-operative vein mapping, the functional diameter of the vein can be predicted and vein utilisation may be increased.
authors.affiliation: Department of Vascular Studies, Bristol Royal Infirmary, U.K.
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
authors.forename: T R
authors.initials: TR
authors.lastname: Magee
authors.forename: D R
authors.initials: DR
authors.lastname: Jones
authors.forename: J K
authors.initials: JK
authors.lastname: Hayward
authors.forename: R N
authors.initials: RN
authors.lastname: Baird
authors.forename: M
authors.initials: M
authors.lastname: Horrocks
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000637:transplantation; D014463:Ultrasonography