[The role of intra-operative Prostavasin application during crural bypass surgery]

The aim of this study was to evaluate the role of intra-operative Prostavasin application during crural bypass surgery. 68 Patients, who underwent infrainguinal autologous vein bypass surgery, were prospectively analyzed.

Intra-operative flow measurements and Prostavasin administration were performed in all patients. The mean flow was 105 ml / min (minimal flow 18 ml / min, maximal flow 321 ml / min). The means of maximal and minimal flow were 329 und 30 ml / min, respectively. The mean of the calculated Pulsatility index was 3.1. The mean flow volume increased after administration of Prostavasin in all patients with a mean increase of 103 %. The Pulsatility index decreased by 39 %. Primary and secondary patency rates after 1 year were 70.3 % und 73.1 %, respectively. The differentiated analyses of the region of the distal anastomoses (popliteal / crural) showed a statistically significant bigger increase of Q after Prostavasin application for infrainguinal popliteal bypasses compared to patients with crural reconstructions (p = 0.05). In addition, the decrease of the Pulsatility index was significantly higher in popliteal grafts (p = 0.03). Patients with early bypass graft failure showed a significantly smaller decrease of PI after Prostavasin application compared to the other patients.

The profit of intra-operative arterial Prostavasin application is first of all an immediate one. The injection of Prostavasin leads to an instant vessel dilatation. This allows the surgeon to get an impression of the flow capacity of the bypass. The Pulsatility index as an indicator for resistance is an important factor for bypass patency.