Arterial Graft Failure

Slevin, Mark; Bontaș, Ecaterina

doi:10.1007/978-3-319-26515-5_23

Cited by 1 publication

(1 citation statement)

References 197 publications

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“…2,7 Recently, several authors have supported the superiority of arterial vascular grafts compared with venous grafts in the reconstruction of arterial defects based on higher long-term patency rates. [9][10][11][12][13] The greatest evidence comes from studies performed on patients undergoing aortocoronary by-pass revascularization [9][10][11]14,15 : Webb et al 10 have postulated that radial artery bypasses, compared with great saphenous vein grafts, showed a flow-mediated dilation 5 years postoperatively, and Collins et al 9 showed a higher percentage of patency of radial arteries and internal mammary arterial grafts compared with great saphenous vein grafts 5 years after surgery. Slevin et al 15 have also shown that arterial grafts yield a lower incidence of myocardial infarction, lower reoperation rates, and longer survival rates.…”

Section: Discussionmentioning

confidence: 99%

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Toia

Zabbia

Roggio

et al. 2017

J reconstr Microsurg

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Background The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (six flow-through flaps, one arterial graft), combined arterial and venous reconstruction in four cases (three vein grafts, one combined venous/arterial graft), and venous reconstruction in one case (one venous graft). The rate of complications and donor-site morbidity related to vascular graft harvest were evaluated. Results Reconstruction was successful in all cases, despite an overall complication rate of 17 and 8% of surgical revision. Donor-site morbidity, subjectively evaluated, was minimal with respect to functional deficits and aesthetic outcome. Indications for the different types of grafts are discussed. Conclusion The use of vascular grafts is needed in a relevant percentage of microsurgical reconstruction cases. Venous and arterial vascular grafts, transient arteriovenous fistulas, and “flow-through” microsurgical flaps showed a safe reconstruction comparable to microsurgical reconstructions without the use of grafts. Donor-site morbidity secondary to vascular graft harvest is minimal, and in almost 70% of cases no additional scars are needed.

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