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A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 2000 June;7(2):95-104

language: English, Italian

An ultrasonographic and histological method to evaluate the internal saphenous vein as a peripheral bypass graft

Carlesi R., Casini A., Dell’Aglio D., Milesi M. *, Gabrielli L.

From the Istituto di Chirurgia Vascolare e Angiologia * Laboratorio di Ricerche Cliniche Anatomia ed Istologia Patologica Istituti Clinici di Perfezionamento Università ­degli Studi, Milano, Italy


Background. To eval­u­ate wheth­er ultra­son­o­graph­ic meas­ure­ment of the saph­e­nous ­vein com­pli­ance, for use as a periph­er­al ­bypass, is cor­re­lat­ed to its his­to­log­i­cal char­ac­ter­is­tics and is there­fore a pre­dic­tor of ­bypass suc­cess.
Methods. Saphenous ­vein com­pli­ance was eval­u­at­ed pre­op­er­a­tive­ly ­using ­colour Doppler ultra­so­nog­ra­phy in 12 ­patients suf­fer­ing ­from chron­ic crit­i­cal leg ische­mia due to under­go femor­o­dis­tal arte­ri­al recon­struc­tion. The inter­nal diam­e­ter of the ­vein was meas­ured at the 3rd ­median of the ­thigh ­with an occlu­sion pres­sure of 50 mmHg and at 10-sec­ond inter­vals up to 120 sec­onds. Intraoperative biop­sy fol­lowed by his­to­log­i­cal anal­y­sis was ­used to eval­u­ate the thick­ness of the tuni­ca inti­ma and the ­walls, as ­well as the pres­ence of mus­cle-­type ­cells in the inti­ma, cor­re­lat­ing ­results ­with ­vein ­graft paten­cy or sten­o­sis/throm­bo­sis.
Results. The ­mean ­increase in ­basal diam­e­ter at 120 sec was 0.95±0.44 mm and 23.0±10.3%; ­mean inti­mal thick­ness was 0.05±0.06 mm, parie­tal thick­ness was 0.73±0.31 mm and mus­cle ­type ­cells ­were ­present in the inti­ma in 33.3% of cas­es. In saph­e­nous ­veins ­that had devel­oped sten­o­sis or throm­bo­sis com­pared to ­those ­which ­were ­still pat­ent, the ­mean ­increase in ­basal diam­e­ter was respec­tive­ly 0.57±0.15 and 1.15±0.41 mm (p=0.39) and 15.7±5.6 and 30.4±8.5% (p=0.01); inti­mal thick­ness was 0.07±0.09 and 0.04±0.03 mm (p=0.04), parie­tal thick­ness was 0.84±0.42 and 0.67±0.22 mm (p=0.07), and mus­cle ­type ­cells ­were ­present in the inti­ma in 50 and 25% of cas­es (p=0.4).
Conclusions. Saphenous ­veins ­with great­er lev­els of com­pli­ance and ­reduced inti­mal thick­ness ­showed a ­reduced inci­dence of ­vein ­graft sten­o­sis or throm­bo­sis.

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