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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2006 Marzo;13(1):11-4
The “unsuitable” saphenous vein in arterial surgery: old and new concepts
Schiavetta A., Borgognoni M., Drago G., Patrone P.
Department of Vascular Surgery, Santa Corona Hospital Pietra Ligure (Savona), Italy
Aim. Revascularisation procedures in vascular surgery often require the use of the greater saphenous vein (GSV) as conduit of choice. For this reason, vascular surgeons should try to reduce the number of “unsuitable” veins, in order to increase the use of autologous conduits. The purpose of this paper is to evaluate the present role of GSV in obstructive arterial surgery of infra-inguinal district, when the use of “unsuitable” veins becomes mandatory.
Methods. This unrandomised study was carried out in a tertiary care center and data collected prospectively from January 2003 to April 2004 in a consecutive sample of 48 infrainguinal by-passes with the use of autologous veins performed at S. Corona Hospital. Among the patients included in this study, 8% (4/48) patients received a by-pass with a “small” vein (caliper 1.8 to 2.1 mm) and 4% (2/48) patients received a by-pass with a varicose vein (caliper 5 to 6 mm). All by-passes were performed under general or spinal anesthesia; the veins were employed in transposed, inverted or in situ fashion.
Results. Thirty-day mortality and patency rates were respectively 4.1% (2/48) and 95.6% (44/46).
Conclusion. During infrainguinal aterial surgery, it is possible sometimes, through a careful evaluation, to extend the employ of previously defined “unsuitable” veins, in selected cases, when it is mandatory to avoid the use of prosthetic materials (i.e. infected fields). Further evaluations on larger series and longer follow-ups are suggested, so that results may be consistently useful in clinical practice.