Use of preliminarily prepared v. cephalica in operations of femoral-distal bypass grafting.
Presented herein is the authors'experience in using a preliminarily prepared lateral subcutaneous vein of the arm (v. cephalica) for femoral-distal reconstructions in a total of nine patients with lower-limb critical ischaemia (LLCI). The choice of the vein referred to above as a bypass graft was a forced one because of a loose-type, insufficient-diameter greater saphenous vein (GSV), varicose and postphlebitic alterations therein or merely the total lack thereof after previous phlebectomy, with such a decision also influenced by no adequate lesser saphenous vein (LSV) available. Given the anticipated level of the would-be distal anastomoses, utilizing synthetic prosthetic grafts of blood vessels seemed fterly undesirable, and immediately employing upper-limb veins as bypass grafts turned out virtually impossible owing to their small diameter. The preparation of the bypass graft consisted in first forming a fistula between the radial artery and v.cephalica in the lower third of the forearm. Theprocedure involvinga 2-to-3-week functioning of the fistula and the so-called "training", of the vein according to a specially devised technique was followed by a noticeable widening of the lumen of the v. cephalica, thus allowing us in the long run to successfully use it for femoral-distal reconstructions.
Alukhanian
O A
OA
Advanced Medical Training Department, Kuban State Medical University, Krasnodar, Russia.
Martirosian
Kh G
KhG
Aristov
D S
DS
D000368:Aged; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000601:surgery; D012501:Saphenous Vein / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014680:Veins / Q000601:surgery*