Arm Vein as an Alternative Autogenous Conduit for Infragenicular Bypass in the Treatment of Critical Limb Ischaemia: A 15 Year Experience

Neto, Farias; Sandri, Giuliano A.; Kalaf, Marcelo Jorge; Matielo, Marcelo Fernando; Casella, Ivan Benaduce; Godoy, Maria de Fátima Guerreiro; Cury, Marcus Vinícius Martins; Sacilotto, Roberto

doi:10.1016/j.ejvs.2014.01.019

Cited by 34 publications

(6 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternative autologous vein sources, such as an arm vein, 33 lesser saphenous vein, 7 or composite autogenous vein, 8 are currently considered the best second choice. 34 in a meta-analysis of alternative autologous vein bypass grafts to infrapopliteal arteries, reported far superior results to those reported for nonautologous grafts (5-year secondary patency of 66.5% and limb salvage of 76.4%).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of cold-stored venous allograft for below-knee bypasses in patients with critical limb ischemia

Ziza

Canaud

Gandet

et al. 2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

Cold-stored venous allografts may be used for performing infragenicular revascularization for CLI with acceptable safety and efficacy results despite poor long-term patency. Their level of performance remains inferior to autologous vein sources but seems comparable to alternative allografts or prosthetic conduit. Their availability is a major advantage compared with other biologic alternative sources.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes of cold-stored venous allograft for below-knee bypasses in patients with critical limb ischemia

Ziza

Canaud

Gandet

et al. 2015

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…Although the cephalic and basilic veins may be used as a single segment, they are often combined into a composite conduit to provide sufficient length in the setting of infrainguinal surgery. Single-segment cephalic vein has been shown to have the best durability of the three options 45. One long-term study revealed 5-year patency and limb salvage rates of 55% and 72%, respectively 34.…”

Section: Bypass and Expected Outcomesmentioning

confidence: 99%

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Komshian

Pike

et al. 2017

VHRM

View full text Add to dashboard Cite

Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0–5.3%), graft failure (12–60%), and amputation (5.7–27%), and more systemic issues include cardiac (2.6–18.4%), respiratory (2.5%), renal (4%), neurovascular (1.5%), and thromboembolic (0.2–1%) complications. While such outcomes present an additional challenge to the postoperative management of surgical patients, it may be possible to minimize their occurrence through careful risk stratification and preoperative assessment. Therefore, individualized selection of candidates for open repair requires weighing the need for intervention against the likelihood of adverse outcomes based on preoperative risk factors. This review provides an overview of open reconstruction, focusing on identifying the clinical indications for surgery and perioperative morbidity and mortality.

show abstract

“…6,7 AV is the third potential autologous alternative with good short- and long-term results. 5,10,11,23 The continuous basilic or cephalic vein provides enough length to reach infragenual target arteries, but especially the forearm segments may not always be of sufficient quality.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Prosthetic conduits show acceptable results for above-knee reconstructions but the results for below-knee bypass are less promising. 8 -11…”

Section: Introductionmentioning

confidence: 99%

The Upper-Arm Basilic-Cephalic Loop: A Valueable Alternative for Below-Knee Arterial Reconstruction

Enzmann

Metzger

Martin

et al. 2021

Vasc Endovascular Surg

View full text Add to dashboard Cite

Introduction: Despite advances of endovascular interventions, bypass surgery remains the gold standard for treatment of long and complex arterial occlusions in the lower limb. Autologous vein is regarded superior to other options. As the graft of first choice, the great saphenous vein (GSV) is often not available due to previous bypass, stripping or poor quality. Other options like arm veins (AV) are important alternatives. As forearm portions of AVs are often unusable, a graft created from the upper arm basilic and cephalic veins provides a valuable alternative. Patients and Methods: We analyzed consecutive patients treated at an academic tertiary referral center between 01/1998 and 07/2018 using arm veins as the main peripheral bypass graft. Study endpoints were primary patency, secondary patency, limb salvage and survival. Results: In the observed time period 2702 bypass procedures were performed at our institution for below-knee arterial reconstructions. Vein grafts used included the ipsilateral GSV (iGSV; n = 1937/71.7%), contralateral GSV (cGSV; 192/7.1%), small saphenous vein (SSV; 133/4.9%), prosthetic conduits (61/2.3%) and different configurations of AV (379/14%). In the majority of patients receiving AV grafts a complete continuous cephalic or basilic vein (CAV) was used (n = 292/77%). If it was not possible to use major parts of these 2 veins, either spliced arm vein grafts (SAV) (42/11%) or an upper arm basilic-cephalic loop graft (45/12%) were used. Median follow-up was 27 (interquartile range: 8-50) months. After 3 years secondary patency (CAV: 85%; SAV: 62%; loop: 66%; p = 0.125) and limb salvage rates (CAV: 79%, SAV: 68%; loop: 79%; p = 0.346) were similar between the 3 bypass options. Conclusion: The encouraging results of alternative AV configurations highlight their value in case the basilic or cephalic veins are not useable in continuity. Especially for infragenual redo-bypass procedures, these techniques should be considered to offer patients durable revascularization options.

show abstract

Arm Vein as an Alternative Autogenous Conduit for Infragenicular Bypass in the Treatment of Critical Limb Ischaemia: A 15 Year Experience

Abstract: The favourable long term results of secondary patency and limb salvage rates encourage the use of arm veins as alternative conduits for infragenicular bypass surgery.

Cited by 34 publications

References 31 publications

Outcomes of cold-stored venous allograft for below-knee bypasses in patients with critical limb ischemia

Outcomes of cold-stored venous allograft for below-knee bypasses in patients with critical limb ischemia

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

The Upper-Arm Basilic-Cephalic Loop: A Valueable Alternative for Below-Knee Arterial Reconstruction

Contact Info

Product

Resources

About