Does saphenous vein arterialisation prevent major amputation in critical leg ischaemia? A comparative study.

BACKGROUND

Arterialisation of the great saphenous vein has been suggested to improve distal circulation in patients with critical leg ischaemia not accessible for reconstructive surgery. As the technique has been a matter of controversy the aim was to assess the outcome of a series of own patients treated with arterialisation and compare them with conservatively treated patients.

EXPERIMENTAL DESIGN

a retrospective cohort study.

SETTING

an academic referral centre (Department of Surgery, Helsinki University Central Hospital) together with a district hospital (Peijas-Rekola Hospital).

PATIENTS AND INTERVENTIONS

14 consecutive patients with critical leg ischaemia treated with arterialisation of the great saphenous vein in the district hospital were compared with 14 age, sex, diabetes and symptom severity-matched controls with critical leg ischaemia treated conservatively in the academic referral centre.

MEASURES

major amputations and patient survival.

RESULTS

The leg salvage rate was 57% at one year in the arterialisation group and 54% in the conservative group (NS) but the survival rate at one year was 92% in the operative group and 64% in the control group (NS).

CONCLUSIONS

Arterialisation did not have any effect on leg salvage. The results of this study do not support the use of arterialisation as a treatment for critical leg ischaemia