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Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement
09:50

Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

Published on: October 1, 2014

Results of in-situ saphenous vein bypass to the foot

E J Clifford1, R E Fry, G P Clagett

  • 1University of Texas Southwestern Medical Center, Department of Surgery, Dallas.

American Journal of Surgery
|December 1, 1989
PubMed

Insights

Vascular reconstruction to pedal vessels is effective for limb salvage in severe tibial-peroneal atherosclerosis. This approach offers comparable outcomes to bypasses to more proximal sites, benefiting patients with critical limb ischemia.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Peripheral Artery Disease

Background:

  • In-situ saphenous vein bypass is a common treatment for critical limb ischemia.
  • Extending bypass to pedal vessels is considered for severe tibial-peroneal atherosclerosis when proximal targets are unsuitable.

Purpose of the Study:

  • To evaluate the efficacy of in-situ saphenous vein bypasses to pedal vessels compared to infragenicular vessels.
  • To assess limb salvage, graft patency, and functional status in patients undergoing bypass to distal arteries.

Main Methods:

  • Retrospective analysis of 115 in-situ saphenous vein bypasses to infragenicular (Group 1, n=91) and pedal vessels (Group 2, n=24).
  • Life-table analysis was used to compare outcomes at 36 months postoperatively.
  • Patient data included indication for surgery, diabetes status, and preoperative noninvasive testing.

Main Results:

  • No significant differences in limb salvage, graft patency, or functional status were observed between Group 1 and Group 2 (p = 0.38).
  • Diabetes did not impact reconstruction success.
  • Preoperative noninvasive testing did not predict graft failure.

Conclusions:

  • Bypass grafting to pedal arteries is a viable option for patients with severe tibial-peroneal atherosclerosis.
  • Outcomes for pedal bypasses are comparable to those for more proximal infragenicular bypasses.
  • Limb salvage rates closely mirrored graft patency and functional status, highlighting the severity of disease in the studied population.

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