Use of arm veins for lower extremity arterial bypass--results, anatomical features and technical considerations.

Full Abstract

Forty lower limb bypasses using arm veins were performed on 37 patients. The indications for surgery were limb threat in 50% of cases, graft failure in 33%, aneurysms in 10% and claudication in 7%. Saphenous veins were absent because of prior use in 73% of cases, and because they were unsuitable in 27%. A single vein was used in 48%, 2 veins in 40% and 3 veins in 12% of cases. Seventy-four per cent of cases had a single-vessel run-off below the distal anastomosis. Eighty-two per cent of the distal anastomoses were to infrapopliteal arteries. The primary and secondary rates of these 40 bypasses at a mean follow-up of 14 months (range 1-40 months) were 74% and 90%, respectively. Limb salvage was 94%. Peri-operative morbidity and mortality were 23% and 3%, respectively. The anatomical and technical aspects of harvesting arm veins are critical to the success of this procedure and will be emphasised. We have found arm veins to be a durable source of accessible autogenous grafts for lower limb revascularisation in the absence of suitable saphenous veins.

Author information

Author/s: Browning, N (N); Zammit, M (M); Rodriguez, D (D); Sauvage, L (L); Loudenback, D (D); Raghavan, A (A);

Affiliation: Providence Medical Center, Seattle, Washington, USA.

Journal and publication information

Publication Type: Journal Article

Journal: South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie (S Afr J Surg), published in SOUTH AFRICA. (Language: eng)

Reference: 2000-May; vol 38 (issue 2) : pp 36-41

Dates: Created 2000/09/21; Completed 2000/09/21; Revised 2004/11/17;

PMID: 10967693, status: MEDLINE (last retrieved date: 2/18/2009)

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