Successful Long-term Limb Salvage Using Cephalic and Small Saphenous Vein Grafts: A Case Report

Overview

Journal Int J Crit Illn Inj Sci

Specialty Critical Care

Date 2021 Jan 7

PMID 33409129

Authors

Omer Faruk Cicek

Ersin Kadirogullari

Eren Gunertem

Adem Diken

Adnan Yalcinkaya

Mustafa Cuneyt Cicek

Alper Uzun

Kerim Cagli

Affiliations

Soon will be listed here.

Abstract

In this case report, we present a patient scheduled for operation due to critical leg ischemia in whom a bilateral great saphenous vein (GSV) had already been used during previous cardiac and peripheral vascular surgeries. The patient underwent femorofemoral crossover bypass from left to right with a small saphenous vein and right femoropopliteal bypass with cephalic vein (CV) during the same session. Distal pulses became palpable, and symptoms regressed dramatically following the operation. A control computed tomographic angiography scan revealed no signs of graft stenosis 32 months after the surgery. Despite the recent advances in synthetic graft materials, small saphenous and CVs should be remembered as alternative long-standing conduits in the absence of the GSV.

References

Plecha E, Freischlag J, Seabrook G, Towne J . Femoropopliteal bypass revisited: an analysis of 138 cases. Cardiovasc Surg. 1996; 4(2):195-9. DOI: 10.1016/0967-2109(96)82314-3. View

Norgren L, Hiatt W, Dormandy J, Nehler M, Harris K, Fowkes F . Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg. 2006; 33 Suppl 1:S1-75. DOI: 10.1016/j.ejvs.2006.09.024. View

Weaver F, Barlow C, Edwards W, Mulherin Jr J, Jenkins J . The lesser saphenous vein: autogenous tissue for lower extremity revascularization. J Vasc Surg. 1987; 5(5):687-92. DOI: 10.1067/mva.1987.avs0050687. View

Curi M, Skelly C, Meyerson S, Woo D, Desai T, McKinsey J . Conduit choice for above-knee femoropopliteal bypass grafting in patients with limb-threatening ischemia. Ann Vasc Surg. 2002; 16(1):95-101. DOI: 10.1007/s10016-001-0134-4. View

Twine C, McLain A . Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev. 2010; (5):CD001487. DOI: 10.1002/14651858.CD001487.pub2. View

Setacci C, de Donato G, Teraa M, Moll F, Ricco J, Becker F . Chapter IV: Treatment of critical limb ischaemia. Eur J Vasc Endovasc Surg. 2011; 42 Suppl 2:S43-59. DOI: 10.1016/S1078-5884(11)60014-2. View

Veith F, Gupta S, Ascer E, Samson R, Scher L, Towne J . Six-year prospective multicenter randomized comparison of autologous saphenous vein and expanded polytetrafluoroethylene grafts in infrainguinal arterial reconstructions. J Vasc Surg. 1986; 3(1):104-14. DOI: 10.1067/mva.1986.avs0030104. View

Holzenbein T, Pomposelli Jr F, Miller A, Contreras M, Gibbons G, Campbell D . Results of a policy with arm veins used as the first alternative to an unavailable ipsilateral greater saphenous vein for infrainguinal bypass. J Vasc Surg. 1996; 23(1):130-40. DOI: 10.1016/s0741-5214(05)80043-6. View

Chew D, Conte M, Donaldson M, Whittemore A, Mannick J, Belkin M . Autogenous composite vein bypass graft for infrainguinal arterial reconstruction. J Vasc Surg. 2001; 33(2):259-64; discussion 264-5. DOI: 10.1067/mva.2001.112699. View

10.

Stefanov G, Cheshmedzhiev M, Andreev A, Denchev B, Bachvarov C, Yordanov M . Arterialized cephalic vein as a femoropopliteal bypass graft: A case report. Int J Angiol. 2012; 16(4):146-8. PMC: 2733030. DOI: 10.1055/s-0031-1278270. View

11.

Taylor Jr L, Edwards J, Brant B, Phinney E, Porter J . Autogenous reversed vein bypass for lower extremity ischemia in patients with absent or inadequate greater saphenous vein. Am J Surg. 1987; 153(5):505-10. DOI: 10.1016/0002-9610(87)90803-8. View

12.

Faries P, LoGerfo F, Arora S, Hook S, Pulling M, Akbari C . A comparative study of alternative conduits for lower extremity revascularization: all-autogenous conduit versus prosthetic grafts. J Vasc Surg. 2000; 32(6):1080-90. DOI: 10.1067/mva.2000.111279. View