title: Arm veins versus contralateral greater saphenous veins for lower extremity bypass reconstruction: preliminary data of a randomized study.
abstract: BACKGROUND
  The aim of this randomized study was to determine whether arm vein (AV) or contralateral greater saphenous vein (CGSV) is the better alternative vein source for lower extremity bypass reconstruction.
  
  
  METHODS
  Consecutive patients with absent ipsilateral greater saphenous vein undergoing lower extremity revascularization were allocated to group A (AV bypass) or B (CGSV bypass).
  
  
  RESULTS
  From 6, 2010, to 11, 2013, 64 patients (32 each group) were randomized. In all, 29 of 93 patients had to be excluded for various reasons. Median age was 76 years vs. 71 years (P = 0.01) for group A and B patients. There were no statistically significant differences regarding gender, cardiovascular risk factors, redo bypass procedures (P = 0.77), below-knee bypass procedures (P = 0.61), median bypass length (P = 0.6), and median length of incision on ipsilateral leg to perform anastomoses (P = 0.2) between group A and B patients, respectively. Incisions for vein harvest were longer in group A (P = 0.003). Overall surgical site infections (SSIs, P = 1.0) and SSI from vein harvest (P = 1.0) were equally distributed. No patient was lost to follow-up (17 vs. 18 months, P = 0.74). There was no statistically significant difference regarding primary (P = 0.77) and secondary (P = 0.25) patency rates at 1 year (group A: 52% vs. group B: 54% and group A: 72% vs. group B: 61%) and at 2 years (52% vs. 48% and 64% vs. 61%), respectively. There were 4 vs. 6 major amputations (P = 0.23) and 5 vs. 2 deaths (P = 0.1) in groups A and B during follow-up.
  
  
  CONCLUSIONS
  Preliminary results suggest that both AV and CGSV may serve as a secondary vein bypass graft equally well.
authors.affiliation: Department of Vascular and Endovascular Surgery, PMU, Salzburg, Austria. Electronic address: k.linni@salk.at.
authors.forename: Klaus
authors.initials: K
authors.lastname: Linni
authors.affiliation: Department of Vascular and Endovascular Surgery, PMU, Salzburg, Austria.
authors.forename: Manuela
authors.initials: M
authors.lastname: Aspalter
authors.affiliation: Department of Vascular and Endovascular Surgery, PMU, Salzburg, Austria.
authors.forename: Enzo
authors.initials: E
authors.lastname: Butturini
authors.affiliation: Department of Vascular and Endovascular Surgery, PMU, Salzburg, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Dabernig
authors.affiliation: Department of Vascular and Endovascular Surgery, PMU, Salzburg, Austria.
authors.forename: Siegmund
authors.initials: S
authors.lastname: Guggenbichler
authors.affiliation: Department of Biostatistics, PMU, Salzburg, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hitzl
authors.affiliation: Department of Vascular and Endovascular Surgery, PMU, Salzburg, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hölzenbein
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D001317:Austria; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D061646:Operative Time; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012086:Reoperation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D034941:Upper Extremity / Q000098:blood supply*; D058017:Vascular Grafting / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D014654:Vascular Patency
chemical_list: D005343:Fibrinolytic Agents