Lower extremity arterial revascularization using conditioned small-diameter great saphenous vein

Area of Science:

• Vascular Surgery
• Cardiovascular Medicine
• Regenerative Medicine

Background:

• Small great saphenous veins (GSVs) pose challenges for arterial bypass grafting.
• Effective methods are needed to prepare these vessels for use as conduits.
• Vessel dilation techniques are crucial for successful bypass surgery.

Purpose of the Study:

• To assess the feasibility of increasing the diameter of small GSVs via valvulotomy.
• To determine if these conditioned GSVs can be used for arterial bypass with acceptable patency.
• To evaluate the long-term outcomes of using valvulotomized GSVs in lower extremity revascularization.

Main Methods:

• In situ GSV valvulotomy was performed on 25 patients with small GSVs (2-3 mm diameter).
• GSVs were dilated to >3 mm (below-knee) or >3.5 mm (above-knee) before bypass.
• Arterial bypass surgery utilized the prepared GSV conduit, with follow-up for 3 months and patency assessed up to 2 years.

Main Results:

• Adequate GSV diameter (>3 mm or >3.5 mm) was achieved in 77% of cases.
• Arterial bypass using valvulotomized GSV was performed in 61.5% of patients.
• Two-year primary and secondary patency rates were 69% ± 11.8% and 75% ± 11%, respectively, with no major adverse events.

Conclusions:

• Valvulotomy is a feasible method to enlarge small-diameter GSVs for arterial bypass.
• This technique provides a viable option for lower extremity revascularization when suitable conduits are scarce.
• The use of valvulotomized GSVs demonstrates promising patency and safety profiles.