Sequential in-situ saphenous vein bypass. Early results and technique.
This report summarizes early results with saphenous vein bypass (SVB) utilizing both sequential and in-situ techniques (SIS SVB) in eight limbs requiring limb salvage. SIS SVB was performed to a variety of vessel combinations using "Y" graft, continuous, or vein extension techniques achieving early patency in all limbs, despite pedal arch disease. Postoperatively, there was a significant increase in ankle/brachial Doppler indices (ABI) (P less than 0.001) at dorsal pedal (0.23-0.88) and at posterior tibial (0.32-0.91). Successful isolated popliteal grafting was confirmed by return of phasic Doppler wave forms. All but one limb healed with minimal tissue loss within 1 month of bypass. Preoperative high resolution angiography and clinical Doppler evaluation of saphenous vein anatomy are mandatory to determine candidacy for SIS SVB.
D000792:Angiography; D001158:Arteries / Q000601:surgery; D001161:Arteriosclerosis / Q000175:diagnosis / Q000601:surgery*; D001916:Brachial Artery / Q000502:physiology; D004487:Edema / Q000209:etiology; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008722:Methods; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D011183:Postoperative Complications; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D013977:Tibia / Q000098:blood supply; D014463:Ultrasonography