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Titolo:
THE UPPER ARM BASILIC-CEPHALIC LOOP FOR DISTAL BYPASS-GRAFTING - TECHNICAL CONSIDERATIONS AND FOLLOW-UP
Autore:
HOLZENBEIN TJ; POMPOSELLI FB; MILLER A; GIBBONS GW; CAMPBELL DR; FREEMAN DV; LOGERFO FW;
Indirizzi:
HARVARD UNIV,NEW ENGLAND DEACONESS HOSP,SCH MED,DIV VASC SURG,HARVARDDEACONESS SURG SERV BOSTON MA 02215 HARVARD UNIV,NEW ENGLAND DEACONESS HOSP,SCH MED,DIV VASC SURG,HARVARDDEACONESS SURG SERV BOSTON MA 02215
Titolo Testata:
Journal of vascular surgery
fascicolo: 4, volume: 21, anno: 1995,
pagine: 586 - 594
SICI:
0741-5214(1995)21:4<586:TUABLF>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOWER-EXTREMITY REVASCULARIZATION; LESSER SAPHENOUS-VEIN; AUTOGENOUS VEIN; LIMB SALVAGE; POLYTETRAFLUOROETHYLENE; DISEASE; VALVULOTOMY; ANGIOSCOPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
T.J. Holzenbein et al., "THE UPPER ARM BASILIC-CEPHALIC LOOP FOR DISTAL BYPASS-GRAFTING - TECHNICAL CONSIDERATIONS AND FOLLOW-UP", Journal of vascular surgery, 21(4), 1995, pp. 586-594

Abstract

Purpose: The performance of a graft created from the upper arm basilic and cephalic veins in continuity was investigated. Methods: Retrospective analysis of 50 patients, who underwent 54 distal reconstructionswith an upper arm vein loop graft between February 1989 and October 1993 (male-to-female ratio of 30/20; mean age of 69.2 years, range 39 to 87; 74% had diabetes) was undertaken. Vein grafts were harvested through a near continuous incision, leaving a skin bridge in the cubita. Intraoperative angioscopy was used to exclude endoluminal disease and to directly observe valvulotomy of the nonreversed part of the graft. Results: Operations were performed for limb salvage in 98.2% of 17 primary and 37 reoperative procedures. Eleven femoropopliteal, 33 femorotibial-pedal, seven popliteal-distal, and two outflow jump grafts were performed. The ipsilateral saphenous vein was unavailable because of previous infrainguinal bypass in 35, coronary artery bypass grafting in14, and unsuitable quality in 5 cases. Thirty-eight grafts were used in continuity, and 16 grafts required repair or splicing with additional vein segments. Primary 30-day patency rate was 92.6% (n = 4 occlusions). No operative deaths occurred. The cumulative patency rate at 1 year was 74.4%, the limb salvage rate 90.7%. Conclusions: The upper armvein loop is a durable graft with excellent short-term and midterm patency rates. Sufficient vein length can be obtained to reach the below-knee and midtibial levels. Angioscopic quality assessment is a valuable adjunct to exclude endoluminal disease most commonly occurring in the median cubital vein. Straightening the curve of the median cubital vein and valvulotomy do not influence patency rates. This is a valuable technique for vascular surgeons that enables rescue of ischemic limbs under otherwise difficult circumstances.

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Documento generato il 30/11/20 alle ore 16:20:27