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Abstract: Objectives: Determine if arm veins are good conduits for infrainguinal revascularisation and should be used when good quality saphenous vein is not available. Design: Retrospective study. Materials and methods: We evaluated a consecutive series of infrainguinal bypass (IB) using arm vein conduits from March 2001 to December 2006.We selected arm vein by preoperative ultrasound mapping to identify suitable veins. We measured vein diameter and assessed vein wall quality. We followed patients with systematic duplex imaging at 1 week, 1, 3, 6 and 12 months, and annually thereafter. We treated significative stenoses found during the follow-up. Results: We performed 56 infrainguinal revascularisation using arm vein conduits in 56 patients. Primary patency rates at 1, 2 and 3 years were 65%, 51% and 47%. Primary assisted patencies at 1, 2 and 3 years were 96%, 96% and 82%. Secondary patency rates at 1, 2 and 3 years were 92%, 88% and 88%. The three-year limb salvage rate was 88%. Conclusions: We conclude that infrainguinal bypass using arm vein for conduits gives good patency rates, if selected by a preoperative US mapping to use the best autogenous conduit available. [Copyright &y& Elsevier]

Objectives: To determine whether the initial benefits of spinal cord stimulation (SCS) treatment for critical limb ischemia (CLI) persist over years. Design: Analysis of data prospectively collected for every CLI patient receiving permanent SCS. Follow-up range 12 to 98 months (mean 46±23, median 50 months). Population: 87 patients (28% stage III, 72%stage IV) with unreconstructable CLI due (83%) or not (17%) to atherosclerosis and with an initial sitting/supine transcutaneous pO2 gradient >15mmHg. Methods: Assessment of actuarial patient survival (PS), limb salvage (LS) and amputation-free patient survival (AFPS). Analysis of the impact of 15 risk factors on long-term outcomes using the Fischer''s exact test for categorical variables and the t test for continuous variables. Results: Follow-up was complete for patient and limb survival. A single non-atherosclerotic patient died during follow-up. Among atherosclerotic patients PS decreased from 88% at 1y, to 76% at 3y, 64% at 5y and 57% at 7y. LS reached 84% at 1y, 78% at 2y, 75% at 3y and remained stable thereafter. Diabetes was found to affect LS (p <0.05) and heart disease to reduce PS (p <0.01). AFPS was reduced in heart patients (p <0.01), diabetics (p <0.05) and in patients with previous stroke (p <0.05). Conclusions: In CLI patients the beneficial effects of SCS persist far beyond the first year of treatment and major amputation becomes infrequent after the second year. [Copyright &y& Elsevier]

Introduction: Popliteal artery entrapment syndrome, although uncommon, usually affects young men under 50 years old. Report: We describe the case of a 56 years old woman with acute right limb ischemia due to popliteal and distal arteries thrombosis. She had no history of leg pain and no cardio-vascular risk factor. Diagnosis of popliteal artery entrapment syndrome was made after successful thrombolysis. Treatment was completed surgically. Discussion: Regarding age, sex and clinical manifestation, our patient put together three uncommon features of popliteal artery entrapment syndrome. This diagnosis should be considered even in patients over 50 without any cardiovascular risk factor presenting with subacute or acute limb ischemia. [Copyright &y& Elsevier]