A randomized prospective study of valvulotome efficacy in in situ reconstructions.
OBJECTIVE
To compare the efficacy of valvulotomes during in situ bypass surgery.


METHODS
A randomized prospective blinded study.


METHODS
Thirty PAD patients scheduled for infrainguinal greater saphenous vein bypass were randomized to use of adjustable or fixed valvulotomes for valve destruction. Valvulotomy was performed after construction of the proximal anastomosis. The efficacy of valve destruction was determined by angioscopy after completion of the distal anastomosis by a separate blinded examiner.


RESULTS
A total of 123 valves were evaluated, 61 after use of an adjustable and 62 with a fixed valvulotome. There was no difference ( p = .88) in number of retained valves between the two groups ( n = 16, 17, respectively). The majority of incompletely destroyed valves were found in the proximal parts of the graft (46%, 13 out of 28). The primary patency at 30 days was 100 and 79%, respectively, p = .09).


CONCLUSIONS
No significant difference in efficacy between valvulotomes was found. Both types tend to miss a large proportion of proximal valves.
Malmstedt
J
J
Department of Vascular Surgery, karolinska University Hospital, Stockholm, Sweden. jonas.malmstedt@karolinska.se
Takolander
R
R
Wahlberg
E
E
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017546:Angioscopy; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014656:Vascular Surgical Procedures / Q000295:instrumentation*