Suitable Saphenous Vein Research Articles

Femoro-popliteal bypass simplified.

There is increasing emphasis on carrying femoro-popliteal bypass grafts below the knee and most vascular surgeons agree that reversed saphenous vein makes the best graft. However, some other considerations have become important and deserve consideration. P.T.F.E. grafts in this location have almost as good a long term patency rate as autologous vein grafts. Some very experienced vascular surgeons have indicated their preference for this type of graft, citing some of these pertinent reasons: Peripheral vascular disease usually is associated with lesions in other vessels. Since coronary artery bypass has become so commonly used to stave off myocardial infarction some thought should be given to preservation of suitable saphenous veins for this purpose. Harvesting the saphenous vein adds additional surgical trauma, time, exposure to sepsis, lymphatic interruption and extra incisions. Once we opt for preferential P.T.F.E. grafts, then we start to search for a simpler technique.

Aortocoronary Gore-Tex Graft: 18-Month Patency

Despite widespread success with Gore-Tex (polytetrafluoroethylene) vascular grafts in peripheral artery operations, very little use has been made of this material in aortocoronary bypasses. We present the case of a 61-year-old woman with a 6-month history of angina who was found to have no suitable saphenous vein available at operation and who therefore underwent Gore-Tex bypass grafting to the right coronary artery. Coronary angiograms made 6 months and 18 months postoperatively showed patency of the 6 mm Gore-Tex replacement graft as well as the internal mammary artery placed to the left anterior descending coronary artery. Although frequent follow-up and close observation are recommended in patients with aortocoronary Gore-Tex grafting, the unique design of this material has made it the best alternative for synthetic coronary bypass conduit in the absence of the saphenous veins, particularly when these veins are found to be inadequate only at the time of operation.

POLYTETRAFLUOROETHYLENE (PTFE) GRAFTS FOR HAEMODIALYSIS: PATENCY AND COMPLICATIONS COMPARED WITH THOSE OF SAPHENOUS VEIN GRAFTS

A comparison has been made between polytetrafluoroethylene (PTFE) and saphenous vein as graft material for the construction of arteriovenous fistulas for use in haemodialysis. Fifty patients with PTFE grafts have been examined and compared with 70 patients with saphenous vein grafts. At eighteen months the accumulative patency rate was 69.8% for PTFE grafts and 68.9% for saphenous grafts. Although the PTFE grafts were similar in terms of patency, their complication rate was higher. The infection rate and distal ischaemia rate for PTFE grafts were double those of the vein grafts. Two patients developed median and ulnar nerve paralysis respectively shortly after implantation of PTFE grafts. Because of this it is recommended that their use be restricted to the lower limb. Despite a higher incidence of complications, PTFE grafts are a satisfactory substitute if a suitable saphenous vein is not available.

Arterial below the knee bypass grafts: Experience with the modified bovine heterograft

Fourteen patients underwent femoral-below the knee bypass grafting with the bovine heterograft with an initial patency rate of 64 per cent. If reopened grafts are included, the patency rate is 61 per cent. Therefore, it appears that the bovine graft is an excellent alternative when suitable saphenous vein is not available for below the knee grafts.

Revascularization of Severe Ischemic Legs

This report deals with tibial arteries revascularizations performed on 28 patients since the year 1966 at the 1st Surgical Clinic of the Charles University of Prague, Czechoslovakia. Severeischemic changes with rest pain and necroses were the indications in 22 patients. In all cases a special method was used. It is a combination of semi-closed Thromboendarterectomy with saphenous vein bypass which is led along the vessels in the popliteal fossa to tibial arteries as far as the ankle region. This combination enables successful revascularization also in patients without a suitable saphenous vein.