Back to Search
Start Over
Adjunctive use of the superficial femoral vein for vascular reconstructions.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2012 May; Vol. 55 (5), pp. 1355-62. Date of Electronic Publication: 2012 Mar 28. - Publication Year :
- 2012
-
Abstract
- Objective: Although the superficial femoral vein (SFV) is an accepted treatment for aortic graft infections, this conduit also has potential uses in other areas. Herein, we evaluate our experience using the SFV for arterial and venous bypasses and the arteriovenous (AV) fistula for dialysis access.<br />Methods: Between 1999 and 2011, 42 patients underwent a bypass or a thigh AV fistula using the SFV (31 arterial, four central venous, six AV fistulas, and one common carotid-to-vertebral bypass). Indications for arterial bypass included infected graft (20), critical limb ischemia (nine), and failed bypass (six). Indications for central venous bypass were: superior vena cava syndrome (two), vessel reconstruction due to tumor encasement (one), and central vein occlusion from thoracic outlet syndrome (one). All AV fistulas were created after patients sustained bilateral subclavian vein occlusions from failed upper extremity access. The common carotid-to-vertebral bypass was created due to an occluded vertebral artery with resultant stroke.<br />Results: Kaplan-Meier cumulative patency curves were used. The primary patency rates at 30 days, 1 year, and 3 years were 97.4% (95% confidence interval [CI], 92.41-100), 74.6% (95% CI, 57.89-96.23), and 66.4% (95% CI, 47.06-93.53), respectively. The assisted primary patency rates at 30 days, 1 year, and 3 years were 100% (95% CI, 100-100), 97.1% (95% CI, 91.54-100), and 89% (95% CI, 74.29-100), respectively. Secondary patency rates at 30 days, 1 year, and 3 years were 100% (95% CI, 100-100), 97.1% (95% CI, 91.54-100), and 89% (95% CI, 74.29-100), respectively. Limb salvage rates at 30 days, 1 year, and 3 years were 97.3% (95% CI, 92.21-100), 93.6% (95% CI, 78.35-100), and 93.6% (95% CI, 78.35-100), respectively. Survival rates at 30 days, 1 year, and 3 years were 97.6% (95% CI, 92.95-100), 86% (95% CI, 75.3-98.3), and 86% (95% CI, 75.3-98.3), respectively. Follow-up ranged from 1 month to 8.7 years (mean time, 21 months). Complications occurred in 22 patients (52%) and included wound complications (n = 19; 45.2%); deep vein thrombosis (n = 1; 2.4%); anastomotic breakdown (n = 1; 2.4%); hematoma (n = 4; 9.5%); pulmonary embolism (n = 2; 4.8%); and compartment syndrome (n = 2; 4.8%).<br />Conclusions: The SFV is a durable conduit for uses beyond aortic reconstruction and should be considered when the great saphenous vein is not available or size match is a concern. However, wound complications remain a problem.<br /> (Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.)
- Subjects :
- Aged
Catheter-Related Infections etiology
Catheter-Related Infections physiopathology
Disease-Free Survival
Female
Humans
Ischemia surgery
Kaplan-Meier Estimate
Limb Salvage
Male
Middle Aged
Ohio
Postoperative Complications etiology
Reoperation
Retrospective Studies
Superior Vena Cava Syndrome surgery
Thoracic Outlet Syndrome surgery
Time Factors
Treatment Outcome
Vascular Diseases etiology
Vascular Diseases physiopathology
Vascular Patency
Arteriovenous Shunt, Surgical methods
Blood Vessel Prosthesis adverse effects
Catheter-Related Infections surgery
Femoral Vein surgery
Lower Extremity blood supply
Renal Dialysis
Vascular Diseases surgery
Vascular Surgical Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 55
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 22459743
- Full Text :
- https://doi.org/10.1016/j.jvs.2011.11.129