title: Distal vein patch as a form of autologus modification for infragenicular prosthetic bypass.
abstract: BACKGROUND
  Preferred graft for infragenicular bypass is autologus vein. The problem is when there is not available autologus vein. Literature suggest that in these situations, prosthetic graft with some form of modification of distal anastomosis with autogenic tissue is valuable adjunctive. Frequently used modifications are Miller's cuff, Taylor's patch and St. Mary's boot. Recently, there are reports on "Distal vein patch" as a form of autologus modification which, due to its simplicity and patency rate, attracted attention. The aim of this study was to evaluate benefits of this novel modification by comparing its patencies with other autologus modification of distal anastomosis.
  
  
  METHODS
  Study was performed on 60 patients, diabetics, with critical limb ischemia (CLI). Patients were divided in two groups: Group with distal vein patch modification; and group with some other form modification - control group. Patients were followed at least 22 months. We examined patency of grafts by physical examination or using Color Doppler. For statistical purposes we used KIaplan Meier analysis and curve. Significance was determined by Mann-Whitney, Fisher's exact, Pearsons chi square or Student T test as appropriate. P value less than 0,05 was considered significant.
  
  
  RESULTS
  Groups were fairly matched relative to demographics, risk factors, operative intervention and distal anastomosis site. There was not statistical difference in two year primary patency between distal vein patch and control group--50% vs 53% respectivly (X2 = 0,08; p = 0,773). Also, there was not statistically significant difference in extremity survival (77% vs 77%) and patient survival between groups (89% vs 93%; X2 = 2,458; p = 0,117).
  
  
  CONCLUSIONS
  This study proved equivalent patencies of infragenicular prosthetic bypasses performed using distal vein patch technique as with any other modification of distal anastomosis.
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina. dragan.totic@gmail.com
authors: Dragan
authors: D
authors: Totic
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Nedzad
authors: N
authors: Rustempasic
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Muhamed
authors: M
authors: Djedovic
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Sid
authors: S
authors: Solakovic
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Haris
authors: H
authors: Vukas
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Ilijas
authors: I
authors: Aslani
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Alma
authors: A
authors: Krvavac
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Dzejra
authors: D
authors: Rudalija
authors: Clinic for Vascular Surgery, Clinical Center of University of Sarajevo, Bosnia and Herzegovina.
authors: Alen
authors: A
authors: Ahmetasevic
mesh_terms: D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D048909:Diabetes Complications / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply; D015996:Survival Rate; D014680:Veins / Q000601:surgery / Q000637:transplantation*