Use of Hand Held Doppler to identify venous tributaries in in situ vein arterial bypass

Riaz, Amjid; Shukla, Rajeev; Ng, K. L.; Ormiston, M. C.

doi:10.1111/j.1445-2197.2009.04951.x

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…3 However, the likelihood of wound complications can be reduced by identifying side vein branches using ultrasound, angiography, or angioscopy during the vein bypass grafting procedure and then selectively ligating the side branches through a series of small incisions. 4 Although these incisions are significantly shorter, they do still carry a significant risk of skin necrosis (13%).…”

Section: Resultsmentioning

confidence: 99%

Percutaneous glue embolization of arteriovenous fistula of in situ saphenous vein bypass graft: Case report and literature review

2021

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Objectives Arteriovenous fistulas (AVFs) of an in situ saphenous vein bypass can be managed surgically or through endovascular coil embolization. The complications associated with the surgical wounds required for side branch ligature can be minimized through selective vein ligature and interrupted small incisions, but endovascular methods are time-consuming and limited by vein size. In this case report, we describe percutaneous ultrasound (US)-guided balloon-assisted direct glue injection as an alternative treatment strategy for AVF closure. Methods We treated a patient with a delayed AVF in a femoral-popliteal in situ saphenous vein bypass. The patient came to our attention for the recurrence of chronic limb-threatening ischemia (CTLI) 4 years after the initial bypass creation. Ultrasound and computed tomography angiography (CTA) showed a double tandem graft in significant stenosis below an AVF connected with the deep venous system. Treatment included percutaneous angioplasty of the bypass stenosis and contemporary AVF closure via ultrasound-guided glue injection. Results We successfully performed endovascular angioplasty with a drug-eluting balloon of the bypass stenosis and ultrasound-guided fistula embolization with cyanoacrylate Glubran 2. Angiography after the procedure showed bypass graft patency, no residual stenosis, and complete closure of the AVF. Results were confirmed with US. Conclusions Percutaneous embolization using glue could be a useful technique for AVF closure. It is a minimally invasive method that reduces the need for skin incisions during in situ saphenous grafting or endovascular revascularization.

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Section: Resultsmentioning

confidence: 99%

Percutaneous glue embolization of arteriovenous fistula of in situ saphenous vein bypass graft: Case report and literature review

2021

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“…Likewise, the use of a handheld Doppler has been introduced to identify venous tributaries. 9 Although the in situ operation was first an open procedure, with a long skin incision to identify and ligate the vein branches, complications of the long incision often included pain, infection, and poor wound healing. Once the location of tributaries could be accurately identified by Doppler scanning, angiography, or angioscopy, the tributaries could then be ligated through small local incisions.…”

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confidence: 99%

The history of the in situ saphenous vein bypass

Connolly

2011

Journal of Vascular Surgery

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Use of Hand Held Doppler to identify venous tributaries in in situ vein arterial bypass

Abstract: This technique is an effective, cheap and simple means of performing bypass surgery in high-risk patients (with significant comorbidity and a high ASA score) and also reducing inherent complications associated with the length of the incision.

Cited by 2 publications

References 15 publications

Percutaneous glue embolization of arteriovenous fistula of in situ saphenous vein bypass graft: Case report and literature review

Percutaneous glue embolization of arteriovenous fistula of in situ saphenous vein bypass graft: Case report and literature review

The history of the in situ saphenous vein bypass

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