External reinforcement of varicose veins with PTFE prosthesis in infrainguinal bypass surgery -- clinical results.
OBJECTIVE
Segmental varicose degeneration of the autogenous greater saphenous vein may limit its use in infrainguinal bypass surgery. Wrapping a PTFE prosthesis around dilated veins has emerged as an option to create externally reinforced vein bypasses. Results regarding graft patency and limb salvage were analyzed.


METHODS
Between September 1995 and January 2001, 35 infrainguinal bypass operations in 33 patients were performed with greater saphenous veins exhibiting segmental varicose dilatation. Grafts were followed by duplex scan and retrospective analysis of graft patency and limb salvage was performed.


RESULTS
One bypass prompted successful revision for early occlusion. Four bypasses required additional reintervention during follow-up. 48 months primary, primary assisted and secondary patency rates were 66%, 82% and 82%, respectively, with a limb salvage rate of 97%. Duplex scan failed to demonstrate stenosis of the reinforced vein segments or aneurysmal degeneration of the residual vein.


CONCLUSIONS
External reinforcement with a PTFE prosthesis allows the use of autogenous greater saphenous veins with varicose dilatation and enables the construction of all autogenous bypasses with promising graft patency and limb salvage.
Department of Cardiothoracic and Vascular Surgery, Johannes Gutenberg-University School of Medicine, Mainz, Germany. neufang@mail.uni-mainz.de
A
A
Neufang
B
B
Dorweiler
C
C
Espinola-Klein
J
J
Reinstadler
D
D
Kirsch
W
W
Schmiedt
H
H
Oelert
D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000401:mortality; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D012720:Severity of Illness Index; D016019:Survival Analysis; D013995:Time; D013997:Time Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D014654:Vascular Patency / Q000502:physiology
D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene