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KMID : 1037520160320040160
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Vascular Specialist International
2016 Volume.32 No. 4 p.160 ~ p.165
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Lower Extremity Arterial Bypass with Arm Vein Conduits and Literature Review
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Park Dae-Joon
Park Yang-Jin
Yoon Kyoung-Won
Heo Seon-Hee
Kim Dong-Ik
Kim Young-Wook
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Abstract
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Purpose: The superiority of autogenous vein conduits is well known in lower extremity arterial bypass (LEAB). Among various alternative conduits for LEAB, long-term results of arm vein grafts were investigated in this study.
Materials and Methods: We retrospectively reviewed clinical characteristics of 28 patients who underwent infrainguinal LEAB with autogenous arm vein grafts at a single institute between January 2003 and December 2015. All procedures were performed in the absence of adequate saphenous veins. Graft patency was determined by periodic examinations with duplex ultrasonography.
Results: Autologous arm vein grafts were implanted for 28 patients (mean age, 60.4±16.8 years; range, 20?82 years; male, 92.9%; atherosclerosis, 19 [67.9%]; and non-atherosclerotic disease 9 [32.1%] including 5 patients with Buerger’s disease). Source of arm vein were basilic 13 (46.4%), cephalic 4 (14.3%) and composition graft with other veins in 11 (39.3%) cases. The level of distal anastomosis was distributed as popliteal in 5 (17.9%), tibio-peroneal in 21 (75.0%) and inframalleolar artery in 2 (7.1%) cases. Mean duration of follow-up was 41.5±46.9 months (range, 1?138 months). Cumulative primary patency rates at 1, 3, and 5 years were 66.5%, 60.9% and 60.9%, respectively. Assisted-primary patency rates at 1, 3 and 5 years were 66.5%, 66.5% and 66.5%, respectively. Secondary patency rates at 1, 3 and 5 years were 70.8%, 70.8% and 70.8%, respectively. There was one limb amputation during the follow-up period.
Conclusion: Arm veins are a useful alternative conduit when great saphenous veins are not available during LEAB.
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KEYWORD
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Arm vein, Lower extremity arterial bypass, Result
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