[Sub-crural bypasses via saphenous vein in situ. Predictive factors of early occlusion].
Twenty-six early occlusions were encountered in a series of 155 infrainguinal saphenous vein bypasses for arterial disease. By univariate and logistic regression analysis, two predictive factors were found to be strongly associated with early occlusion: vein fibrosis (F) and uncorrected intraoperative arteriographic anomaly (A). Regression coefficients were 0.775 +/- 0.343 for F and 1.125 +/- 0.352 for A. The probability (p) of early occlusion of bypass is: [formula; see text] (Exp = Exponent) The vein diameter, the quality of run-off, the site of anastomosis and the length of the bypass were not predictive of early occlusion. We conclude that 1) the presence of fibrous ipsilateral saphenous vein should prompt using the contralateral vein, and 2) routine intraoperative arteriograms of the entire length of the bypass should be obtained: any anomaly visible on the intraoperative films should be corrected immediately, even if it seems minute or if bypass flow seems otherwise adequate.
Etienne
G
G
Service de Chirurgie Vasculaire, Hôpital Henri Mondor, Créteil.
Becquemin
J P
JP
Dervanian
P
P
Melliere
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery*
Pontages sous-cruraux par veine saphene in situ. Facteurs predictifs d'occlusion précoce.