Sottiurai V S, Lyon R, Ross C, Cooper M, Gonzales J
Department of Surgery, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.
Eur J Vasc Endovasc Surg. 1996 Feb;11(2):225-9. doi: 10.1016/s1078-5884(96)80057-8.
The possibility of using RING PTFE graft as venous bypass to preserve arteriovenous graft function and reduce upper extremity swelling.
Twenty-two patients with stenosis/occlusion of the brachial-axillary-subclavian vein segment in haemodialysis patients (n = 19) and patients with penetration injury (n = 3) who were not candidates for balloon angioplasty were treated with ring PTFE venous bypass in renal patients and jugular to axillary vein transposition for trauma patients and followed for 10-87 months (mean 31) using venography, Doppler analysis and Duplex scanning.
There was no death or neurologic deficit resulting from the venous bypass. Resolution of swelling occurred in 8-48 h. 19/22 (86%) of the bypasses and 3/3 transpositions remained patent after a mean follow-up of 31 months (10-87) months. The attrition was due to AV graft occlusion (n = 2) and infection requiring graft removal (n = 1).
Ring PTFE graft is an acceptable venous bypass for brachial-axillary-subclavian stenosis/occlusion to reduce arm swelling and preserve the function of AV grafts in patients with lesions not amendable with balloon angioplasty or thrombolytic therapy. Jugular-axillary transposition is inappropriate for renal patients.
