Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 1998 August;39(4) > The Journal of Cardiovascular Surgery 1998 August;39(4):405-11

ULTIMO FASCICOLO
 

JOURNAL TOOLS

Opzioni di pubblicazione
eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Estratti
Permessi
Share

 

ORIGINAL ARTICLES  VASCULAR PAPERS 

The Journal of Cardiovascular Surgery 1998 August;39(4):405-11

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Superficial femoral vein in arterial reconstruction for limb salvage: outcome and fate of venous circulation

Wozniak G., Gortz H.*, Akinturk H., Dapper F., Hehrlein F., Alemany J.*

From the Department of Cardiovascular Surgery, Justus-Liebig-University, Giessen * Department of Vascular Surgery, Knappschafts-Krankenhaus, Bottrop, Germany


PDF


Back­ground. In ­some par­tic­ular ­cases in vas­cular sur­gery it is man­da­tory to per­form arte­rial recon­struc­tion ­using autol­o­gous ­graft. ­Since 1985, we ­have ­been ­using the super­fi­cial ­femoral ­vein for arte­rial sub­sti­tute in the ­case of ­limb sal­vage, ­when ­another autol­o­gous ­vein has not ­been avail­able. We ­made a pros­pec­tive inves­ti­ga­tion on 32 ­patients ­over a ­mean ­period of 24.5±12.1 ­months (1 to 48 ­months) to eval­uate the use­ful­ness of super­fi­cial ­femoral ­vein (SFV) for ­distal arte­rial recon­struc­tive sur­gery and to objec­tify the ­fate of ­venous cir­cu­la­tion of the ­limb ­after ­removal of ­this ­vein.
­Methods. ­There ­were 20 ­male and 12 ­female ­patients aver­aging 64.3±10.3 ­years, who under­went ­crural arte­rial recon­struc­tive sur­gery ­using the com­posite tech­nique (­PTFE and SFV). All ­grafts had ­been ­placed sub­cu­ta­ne­ously in lat­eral to ­knee posi­tion. ­Mean ­length of ­removed super­fi­cial ­femoral ­vein was 13.2±9.4 cm.
­Results. In 6 ­patients (18.7%), we ­found an ­early occlu­sion of ­bypass fol­lowed by ­major ampu­ta­tion in 5 ­cases (15.6%). ­Minor ampu­ta­tion had to be ­done in 12 ­patients (37.5%). Cumu­la­tive ­patency was 56.3% ­after 48 ­months. Fol­lowing the ­removal of super­fi­cial ­femoral ­vein, we had no com­pli­ca­tions due to ­venous ­stasis. We ­found a sig­nif­i­cant ­increase of ple­thys­mo­graph­i­cally meas­ured ­venous ­capacity (1.7±0.49 to 2.51±0.71 [p<0.01]) and ­venous out­flow (14.9±5.34 to 23.9±10.4 [p<0.05]) ­after 7.7 ­months. We did not ­observe ­more sig­nif­i­cant ­changes of ­venous cir­cu­la­tion ­during fur­ther ­follow-up.
Con­clu­sions. ­Despite ­overall ­good ­results, we ­only rec­om­mend the use of super­fi­cial ­femoral ­vein in haz­ardous sit­u­a­tions, ­when ­other autol­o­gous mate­rial is not avail­able.

inizio pagina