Repair lower extremity vascular injury using a parallel connection for reconstruction of vessel graft with autogenous...

Insufficient inner diameter of the autologous vein can negatively affect outcomes in vascular injury repair. This study reports the use of the parallel connection method to improve outcomes and assesses the efficacy and safety of reconstructive treatment for lower extremity vascular injuries using parallel connection vessel grafts from autogenous veins.

This retrospective study included 54 patients who underwent vascular reconstruction for lower extremity vascular injury between March 2015 and January 2023. Patients received either a parallel connection autogenous vein graft or direct autogenous vein reconstruction. Clinical and follow-up data were analyzed, and the two groups were compared in terms of thrombosis rate, amputation rate, and anastomosis time.

The parallel connection method proved more effective than direct autogenous vein grafting for both arterial and venous reconstruction. In arterial reconstruction, the parallel connection group had a significantly lower thrombosis rate (5.88% vs. 53.85%) and amputation rate (0% vs. 38.46%) compared with the direct autogenous vein graft group (both P < 0.05). For venous reconstruction, the thrombosis rate was also significantly lower in the parallel connection group than in the direct autogenous vein graft group (7.69% vs. 57.14%, P < 0.05). However, the procedure time was longer for the parallel connection method than for direct autogenous vein grafting (P < 0.05). No pseudoaneurysm, stenosis, or thromboembolism was observed in the target vessels during the follow-up period (23-60 months).

The results of this study indicate that the parallel connection method yields lower rates of thrombosis and amputation compared with direct autogenous vein grafting in vascular injury reconstruction, although it requires longer operative time. This study has several limitations, including its retrospective design, small sample size, and potential selection bias. Therefore, larger prospective studies are needed to validate these findings.