Early results of endovascular-assisted in situ saphenous vein bypass grafting

D. F. Cikrit, Michael Dalsing, S. G. Lalka, N. F. Fiore, Alan Sawchuk, A. P. Ladd, B. Solooki

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: This study evaluated an endovascular technique for occlusion of arteriovenous fistula when performing saphenous vein in situ bypass grafting. Methods: In 31 limbs femoropopliteal (17) or femorotibial (14) in situ bypass grafting was performed for claudication/aneurysm (4), rest pain (6), or tissue loss (21). A valvulotome was used for valve lysis. Saphenous vein branches were identified with angioscopy in 16 limbs or with fluoroscopy in the remainder. An electronically steerable endovascular catheter was used to deliver platinum coils into the venous tributaries to occlude them. Results: The maximal number of coils placed in any limb was nine. Most operations were performed with only a groin incision (length = 9.8 ± 1.6 cm) and a distal incision (length = 16.8 ± 6.5 cm). Wound complications occurred in four limbs, whereas four limbs developed localized superficial thrombophlebitis. The postoperative ankle-brachial index increased to a mean of 0.91 ± 0.12. Postoperative duplex imaging revealed a missed arteriovenous fistula in 12 limbs. Two were surgically ligated, whereas the remainder were embolized in the radiology suite. Postoperative length of hospitalization was 4 ± 2 days in uncomplicated cases. Follow-up revealed five graft occlusions. Occlusion occurred at 12 hours, 2 weeks, and 6, 14, and 15 months after operation. Although there were no perioperative deaths, two patients have died of unrelated causes. Conclusion: This endovascular technique of arteriovenous fistula embolization decreased the length of the surgical wounds, and patients were discharged 4 ± 2 days in uncomplicated cases. The ultimate test of its efficacy, however, will be long-term functional results.

Original languageEnglish
Pages (from-to)778-787
Number of pages10
JournalJournal of Vascular Surgery
Volume19
Issue number5
StatePublished - 1994

Fingerprint

Saphenous Vein
Extremities
Arteriovenous Fistula
Endovascular Procedures
Angioscopy
Ankle Brachial Index
Thrombophlebitis
Groin
Fluoroscopy
Platinum
Radiology
Aneurysm
Hospitalization
Catheters
Transplants
Pain
Wounds and Injuries

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Cikrit, D. F., Dalsing, M., Lalka, S. G., Fiore, N. F., Sawchuk, A., Ladd, A. P., & Solooki, B. (1994). Early results of endovascular-assisted in situ saphenous vein bypass grafting. Journal of Vascular Surgery, 19(5), 778-787.

Early results of endovascular-assisted in situ saphenous vein bypass grafting. / Cikrit, D. F.; Dalsing, Michael; Lalka, S. G.; Fiore, N. F.; Sawchuk, Alan; Ladd, A. P.; Solooki, B.

In: Journal of Vascular Surgery, Vol. 19, No. 5, 1994, p. 778-787.

Research output: Contribution to journalArticle

Cikrit, DF, Dalsing, M, Lalka, SG, Fiore, NF, Sawchuk, A, Ladd, AP & Solooki, B 1994, 'Early results of endovascular-assisted in situ saphenous vein bypass grafting', Journal of Vascular Surgery, vol. 19, no. 5, pp. 778-787.
Cikrit, D. F. ; Dalsing, Michael ; Lalka, S. G. ; Fiore, N. F. ; Sawchuk, Alan ; Ladd, A. P. ; Solooki, B. / Early results of endovascular-assisted in situ saphenous vein bypass grafting. In: Journal of Vascular Surgery. 1994 ; Vol. 19, No. 5. pp. 778-787.
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AU - Sawchuk, Alan

AU - Ladd, A. P.

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