POTENTIALITY OF FEMORO-DISTAL IN SITU VEIN AUTOGRAFTING FOR CRITICAL LOWER LIMB ISCHEMIA

V.V. Knyazhev, D. Golemanov, A. Angelov, A. Anastasov, S. Hrelev, M. Cheshmedzhiev
Vascular Surgery Clinics, Varna Medical University,
Varna, Bulgaria

The early and long-term results of 117 femoro-distal in situ saphenous vein bypasses in 114 patients were analyzed. The indications for reconstruction were: rest pain in 47 cases (40.2%) and peripheral gangrene in 70 cases (59.8%). The distal anastomoses were executed above the knee in 44 cases (37.6%) and below the knee – in 73 cases (62.4%). In 22 patients from the last group one of the tibial arteries was used for anastomoses. In 26 cases vascular reconstruction was combined with lumbar sympathectomy, in 21 – with intraoperative balloon endovascular dilatation. Valvulotomy was performed by "INSITUCAT" (Braum Melsungen A.G.). Early postoperative graft thrombosis occurred in 12 cases (10.3%), 8 of them were successfully reoperated. Eighteen patients (15.4%) ended with amputation, 3 (2.6%) – died. The long-term outcome was obtained in 93 patients with 96 grafts with normal function in hospital period. Cumulative patency of in situ grafts for period of 1, 3, 5 and 8 years was 83.1%, 66.5%, 56.9% and 45.5% respectively.

P. 79-84

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