Relationship between the diameter of the vein graft and postoperative ankle brachial pressure index following femoro-popliteal bypass.
OBJECTIVE
We studied whether the diameter of the saphenous vein graft affects the result of femoro-popliteal bypass surgery.


METHODS
Thirty-eight patients with bypasses from the femoral artery to the above knee popliteal artery were studied. Bypasses without a patent anterior or posterior tibial artery were excluded. The great saphenous vein was used as a bypass graft in 20 extremities and Dacron grafts (6 mm or 8 mm diameter) were used in 18 arteries. The smallest diameter of the saphenous vein was measured preoperatively with ultrasonography. Vein grafts were divided into two groups: small vein graft (< or =3 mm) and large vein graft (> or =3.5 mm). The ankle brachial pressure index (ABI) was measured at 1 week and 3 months after operation.


RESULTS
The diameter of the vein graft (2.5 to 4 mm, 3.4+/-0.5 mm) was positively correlated with postoperative ABI (R2 0.607, P<0.0001). The postoperative ABI at 1 week was significantly lower in the small vein graft group (0.72+/-0.09) than in the large vein graft group (0.95+/-0.11) and in the Dacron graft group (1.05+/-0.16). The ABI at 3 months was still significantly lower in small vein graft group (0.78+/-0.07).


CONCLUSIONS
The diameter of the vein graft was positively correlated with postoperative ABI after femoro-popliteal above knee bypass. Postoperative ABI was lower using a vein graft with a diameter of < or =3 mm than that using a bigger vein graft or a Dacron graft.
Matsushita
M
M
Department of Vascular Surgery, Aichi Cardiovascular and Respiratory Center, Aichi, Japan. matsu85@orihime.ne.jp
Ikezawa
T
T
Banno
H
H
D000368:Aged; D000842:Ankle / Q000098:blood supply*; D001157:Arterial Occlusive Diseases / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D001916:Brachial Artery / Q000503:physiopathology*; D005260:Female; D005263:Femoral Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011150:Popliteal Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014654:Vascular Patency
D011093:Polyethylene Terephthalates