Experimental evidence to support the use of interposition vein collars/patches in distal PTFE anastomoses

Tyrrell, Mark; Chester, J. F.; Vipond, M N; Clarke, G. H.; Taylor, R. S.; Wolfe, John H.

doi:10.1016/s0950-821x(05)80045-3

Cited by 37 publications

(22 citation statements)

References 13 publications

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“…2,17 The mechanism of the vein interposition (patch or cuff) is thought to result in decreased compliance mismatch between the stiff graft and the compliant artery or enlargement of the distal anastomosis so that the formation of hyperplasia must encroach on a wider lumen before becoming clinically significant. [29][30][31] While other authors have been credited with utilizing the vein interposition technique, Siegman 18 was actually the first advocate of the use of a venous cuff in 1979 to facilitate the performance of anastomoses to calcified arteries. While the exact mechanism of how these venous interpositions result in increased patency is unclear, data from randomized animal data suggest a decrease in intimal hyperplasia with the vein cuff.…”

Section: Discussionmentioning

confidence: 99%

A 10-Year Experience with Complementary Distal Arteriovenous Fistula and Deep Vein Interposition for Infrapopliteal Prosthetic Bypasses

Hingorani

Ascher²,

Marks³

et al. 2005

Vasc Endovascular Surg

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Since up to 20% of patients undergoing lower extremity revascularization do not have an adequate venous conduit, some authors have explored the use of prosthetic grafts with adjunctive techniques for lower extremity revascularization. However, the long-term graft patency of those procedures has not been well documented. The purpose of this study was to examine the long-term patency of polytetrafluoroethylene (PTFE) bypass with adjunctive arteriovenous fistula and venous interposition (AVF/VI) for infrapopliteal revascularization. Over a 10-year period, 246 lower extremity reconstructions were performed in 176 (71.5% men) patients with critical ischemia in whom a totally autogenous vein bypass was not feasible. Seventy-six limbs had undergone 1 or more failed ipsilateral infrainguinal bypasses. Indications for surgery were chronic critical limb-threatening ischemia (86%) (rest pain, ischemic ulcer, or gangrene) or acute ischemia (14%). Ages ranged from 46 to 91 years (mean 74 +/-0.6 [SD] years). Risk factors such as diabetes, hypertension, coronary artery disease, end-stage renal disease, and use of tobacco were present in 49%, 49%, 52%, 8%, and 67% of the patients, respectively. During the follow-up, 112 cases (45%) required reinterventions. Twenty-seven patients (15%) required bypass revision twice. During the follow up, 56 limbs (23%) were amputated (above-the-knee amputation 25 (10%); below-the-knee amputation 31 (13%). To date, 150 (85%) patients of a total of 176 are deceased. The primary graft patency rates were as follows: at 1 year, 51%; at 2 years, 41%; 3 years, 35%; and 5 years, 24%. Limb salvage rates were as follows: 1 year, 79%; 2 years, 76%; 3 years 76%; and 5 years, 74%. Patient survival rates were as follows: 1 year, 69%; 2 years, 60%; 3 years, 54%; and 5 years, 40%. Amputation-free patient survival rates were as follows: 1 year, 66%; 2 years, 57%, 3 years, 51%, and 5 years, 30%. This technique appears to offer reasonable patency and limb salvage rates in patients in whom autogenous bypass grafts are not feasible.

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Section: Discussionmentioning

confidence: 99%

A 10-Year Experience with Complementary Distal Arteriovenous Fistula and Deep Vein Interposition for Infrapopliteal Prosthetic Bypasses

Hingorani

Ascher²,

Marks³

et al. 2005

Vasc Endovascular Surg

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“…Several anastomotic variations are used in clinical practice but the state-of-the-art form has not been established. A variety of studies described the local hemodynamics of distal anastomoses using flow visualization with dye injection or laser Doppler anemometry (How et al, 2000;Fisher et al, 2001a, b;Tyrrell et al, 1990;Piorko et al, 2001;Hughes and How, 1996;Wijesinghe et al, 1999). However the use of PIV allows the instantaneous capture of large flow fields with high resolution velocity data and the calculation of parameters which are relevant to fluid dynamics.…”

Section: Discussionmentioning

confidence: 99%

Flow pattern and shear stress distribution of distal end-to-side anastomoses. A comparison of the instantaneous velocity fields obtained by particle image velocimetry

Heise

Schmidt

Krüger

et al. 2004

Journal of Biomechanics

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“…The patency of prosthetic IGABs is affected by aggressive intimal hyperplasia, usually at the distal anastomosis. A collar or patch of vein may be interposed at the distal anastomosis between the PTFE graft and the artery to reduce intimal hyperplasia related to poor compliance of the prosthetic graft (Fig 3) (20,21). There are many varieties available (Miller cuff, Taylor patch, St Mary's hood).…”

Section: Prosthetic Graftsmentioning

confidence: 99%

Multidetector CT Angiography of Infrainguinal Arterial Bypass

et al. 2008

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Infrainguinal arterial bypass (IGAB) surgery is commonly performed in patients with claudication, critical limb ischemia, or other arterial problems in the lower extremities. An IGAB is constructed from different materials depending on the anatomy of the lesion and the availability of an autogenous vein. The ideal material for IGAB is the greater saphenous vein, especially for distal below-knee bypass. In patients with no available autogenous vein, IGAB can be performed by using different prosthetic materials or biologic grafts. After the surgery, periodic surveillance is performed with duplex ultrasonography and clinical assessment of peripheral pulses and ankle-brachial indexes. If complications are detected, further work-up is performed with conventional arteriography, multidetector computed tomographic (CT) angiography, or magnetic resonance angiography. CT angiography has become a powerful tool for assessing the potential early and late complications of IGAB and for planning further therapy in a fast, reliable, and noninvasive manner.

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Experimental evidence to support the use of interposition vein collars/patches in distal PTFE anastomoses

Cited by 37 publications

References 13 publications

A 10-Year Experience with Complementary Distal Arteriovenous Fistula and Deep Vein Interposition for Infrapopliteal Prosthetic Bypasses

A 10-Year Experience with Complementary Distal Arteriovenous Fistula and Deep Vein Interposition for Infrapopliteal Prosthetic Bypasses

Flow pattern and shear stress distribution of distal end-to-side anastomoses. A comparison of the instantaneous velocity fields obtained by particle image velocimetry

Multidetector CT Angiography of Infrainguinal Arterial Bypass

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