Related Experiment Video
Updated: Sep 11, 2025
Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Outcomes After Utilization of Autogenous Arm Vein Grafts for Lower Extremity Bypasses
Roberto S Loanzon1, Hana Shafique2, Christina L Cui1
1Department Surgery, Durham VA Medical Center, Durham, NC; Division of Vascular and Endovascular Surgery, Department of Surgery, Duke University, Durham, NC.
Background:
Lower extremity bypasses performed with autogernous conduit have superior patency and limb salvage. This is often performed with single segment great saphenous vein (GSV), but other options may be required for patients without available GSV. This study presents our experience utilizing arm veins as an alternative autogenous conduit for patients undergoing lower extremity bypass procedures.
Methods:
A single-center retrospective study of patients at a Veterans Affairs Medical Center with peripheral arterial disease (PAD) who underwent lower extremity bypass with arm vein between January 2009 and July 2023 was performed. The primary outcomes were amputation-free survival (AFS) and major adverse limb event (MALE). Secondary outcomes include postoperative complications, such as postoperative surgical site infection, total hospital length of stay, 30-day mortality, and unplanned 30-day readmission.
Results:
From January 2009 to June 2023, there were 42 lower extremity bypasses performed in patients who possessed inadequate GSV. All procedures were performed in men (n = 42, 100%). The median age was 67 years (interquartile range (IQR) 62-71 years). Nine procedures (21.4%) were performed for claudication, 21 (50%) for tissue loss, and 12 (28.6%) for rest pain. The majority involved bypassing to infrageniculate targets (n = 39, 93%). Conduit composition included single (n = 19, 45%), two-piece (n = 19, 45%), or three-piece (n = 4, 10%) composite grafts with arm vein. The median AFS was 3.86 years (IQR 1.19-6.65 years). Five patients required major amputation (15.6%). The median time to MALE was 0.88 years (IQR 0.23-1.69 years). Overall, 30-day mortality was 2.4% (n = 1). Postoperative complications included surgical site infection in 9 patients (21.4%), hematoma in 3 patients (7.1%), early graft thrombosis in one patient (2.4%), wound dehiscence in one patient (2.4%), and a lymph leak in one patient (2.4%). The median length of stay was 6 days (IQR 3.3-9.5 days).
Conclusion:
Arm vein is a viable alternative autogenous conduit for lower extremity arterial bypasses in patients without adequate GSV.
More Related Videos
Related Concept Videos
01:25Hemodialysis I: Introduction
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:15Veins of Lower Limbs
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
01:17Veins of Upper Limbs
The deep venous system is primarily composed of the ulnar and radial veins. The ulnar vein, which drains the fingers through the superficial palmar venous arches, and the radial vein, which serves the palms via the deep palmar...