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A new "closed" in situ vein bypass technique
C H Wittens1, L C van Dijk, N A du Bois
1Department of Vascular Surgery, University Hospital Rotterdam Dijkzigt, The Netherlands.
European Journal of Vascular Surgery
|March 1, 1994
Summary
A new closed technique for coil embolisation of in situ vein bypass side branches avoids long incisions. This minimally invasive approach shows feasibility for achieving long-term occlusion of arteriovenous fistulae.
Area of Science:
- Vascular Surgery
- Interventional Radiology
Background:
- Traditional methods for managing side branches in in situ vein bypass grafts often require extensive skin incisions.
- Minimally invasive techniques are sought to reduce surgical morbidity and improve patient outcomes.
Purpose of the Study:
- To introduce and evaluate a novel closed technique for intraoperative coil embolisation of side branches in in situ vein bypass grafts.
- To assess the feasibility and efficacy of this technique in avoiding long skin incisions and managing arteriovenous fistulae.
Main Methods:
- A co-axial catheter embolisation system was used for selective catheterisation and coil placement in side branches.
- The procedure was performed under fluoroscopic guidance after completion of bypass anastomosis.
- The technique was applied in 16 in situ vein bypasses across 14 patients.
Main Results:
- The embolisation procedure, once mastered, took less than 1 hour.
- Twelve of the 16 bypasses remained patent at a median follow-up of 16 months.
- Four cases required postoperative treatment for persistent arteriovenous fistulae; two major wound complications and three early failures were noted.
Conclusions:
- The developed
- closed
- technique is feasible for intraoperative embolisation of in situ vein bypass side branches.
- This method allows for long-term occlusion of arteriovenous fistulae without the need for surgical ligation and incisions.