Guntani Atsushi, Yamashita Sho, Mii Shinsuke
Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Fukuoka, Japan.
Ann Vasc Dis. 2023 Sep 25;16(3):169-173. doi: 10.3400/avd.oa.22-00122.
: Due to the potential of thrombus blockage and aneurysm rupture, saphenous veins with varicose veins are not advised for use as bypass grafts. However, if no other autologous vein is accessible for use as a conduit in lower-limb bypass; varicose vein transplants may be employed. Few reports have studied the clinical results of lower-limb bypass using varicose vein grafts. We therefore investigated whether or not acceptable patency rates of varicose vein graft for lower-limb bypass could be achieved. : We performed lower-limb bypass using varicose vein graft on nine limbs from June 2017 to May 2020 and conducted a retrospective analysis of prospectively collected data. : Early graft failure following bypass surgery using a varicose vein transplant was not detected, and major complications, such as acute graft occlusion or aneurysm dilatation, were not noted throughout the follow-up period. The primary and secondary patency of varicose vein graft was 70.0% and 100% at 3 years, respectively. : The incidence of major problems of the varicose vein transplants does not seem to be higher than with conventional saphenous vein grafts. If there are no other appropriate autologous veins, a varicose vein graft may be useful as a conduit for bypass surgery.
由于存在血栓阻塞和动脉瘤破裂的风险,不建议使用伴有静脉曲张的大隐静脉作为旁路移植血管。然而,如果没有其他自体静脉可用于下肢旁路手术的管道,可采用曲张静脉移植。很少有报告研究使用曲张静脉移植物进行下肢旁路手术的临床结果。因此,我们调查了下肢旁路手术中曲张静脉移植物是否能达到可接受的通畅率。
2017年6月至2020年5月,我们对9条肢体进行了使用曲张静脉移植物的下肢旁路手术,并对前瞻性收集的数据进行了回顾性分析。
未发现使用曲张静脉移植物进行旁路手术后早期移植物失败,在整个随访期间也未发现急性移植物闭塞或动脉瘤扩张等主要并发症。曲张静脉移植物的一期和二期通畅率在3年时分别为70.0%和100%。
曲张静脉移植物的主要问题发生率似乎并不高于传统大隐静脉移植物。如果没有其他合适的自体静脉,曲张静脉移植物可作为旁路手术的管道。