Venous morbidity after superficial femoral-popliteal vein harvest

Wells, J. K.; Hagino, Ryan T.; Bargmann, K. M.; Jackson, Mark R.; Valentine, R. James; Kakish, Humam B.; Clagett, G. Patrick; Schanzer, Harry; Schulman, Marjorie; Strandness, D. Eugene; Nehler, Mark R.; Rutherford, R. Bruce

doi:10.1016/s0741-5214(99)70381-2

Cited by 109 publications

(103 citation statements)

References 21 publications

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“…Several studies have documented minimal lower extremity venous comorbidities when the vein is harvested between the deep and popliteal veins. 14,16,17 In our case, the trauma service had ligated both the IVC and bilateral iliac veins as a damage control maneuver. The patient subsequently developed early, progressive lower extremity edema.…”

Section: -511mentioning

confidence: 87%

Staged Reconstruction of the Inferior Vena Cava After Gunshot Injury

Droz

Matsuura

2016

Journal of Vascular Surgery

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A 23-year-old man with a gunshot injury to the abdomen and cardiac arrest requiring emergency department thoracotomy had a transection of the distal inferior vena cava (IVC) and small bowel injury. Because of persistent hemorrhagic shock, the IVC was ligated. During the next 3 days, he developed worsening bilateral leg edema. He was taken back for reanastomosis of his small bowel and reconstruction of the IVC using autologous femoral vein harvested from the right leg. We think that patients requiring ligation of the vena cava with worsening leg edema can benefit from a staged reconstruction of the IVC. (J Vasc Surg Cases and Innovative Techniques 2017;3:136-8.) Penetrating injuries of the inferior vena cava (IVC) carry a high mortality. [1][2][3][4][5] In a hemodynamically unstable patient, ligation of the vena cava often becomes necessary as a lifesaving measure. We describe a delayed reconstruction of the IVC using autologous femoral vein after stabilization of the patient. This case demonstrates the value of working with the trauma team in successful resuscitation of severe shock, acidosis, and hypothermia and in control of abdominal contamination before a venous bypass. The patient has consented to this case presentation. CASE REPORTA 23-year-old man arrived in the trauma bay with severe hypotension after a gunshot injury to the abdomen. During emergency department resuscitation, the patient arrested, requiring thoracotomy and aortic cross-clamping. The patient was placed on massive transfusion protocol and transported to the operating room for exploration, with findings of a transected distal IVC involving both origins of the common iliac veins. His aorta and iliac arteries were intact. Because of his persistent hemorrhagic shock, the IVC and both iliac veins were ligated (Fig 1).A segment of small bowel was also injured and treated with we harvested the right femoral vein, between the deep and popliteal veins, and created a bifurcated bypass (Fig 2). The patient was discharged home on clopidogrel and graded compression stockings. His venous duplex ultrasound study at 2 weeks showed a patent bypass. At 1-month follow-up, his incisions were healed and he had no residual leg edema. DISCUSSIONIVC injuries are rare and more often the result of penetrating trauma, occurring in approximately 0.02% of gunshot wounds to the abdomen. 2,6 Mortality of IVC injuries is quoted in most series to be around 50%. 1,2 Factors associated with increased mortality are hypotension on arrival to the emergency department, associated major vascular injury, and level of IVC injury, with proximal injuries carrying the highest mortality (suprahepatic).

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Section: -511mentioning

confidence: 87%

Staged Reconstruction of the Inferior Vena Cava After Gunshot Injury

Droz

Matsuura

2016

Journal of Vascular Surgery

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“…Antoniou et al 5) observed a graft infection or recurrent bleeding in 44% of mid-to long-term venous morbidity after an FV harvest is minimal. 17) The major drawback to this technique is the long operation time. 11) In the present case, we prioritized a resistance to infection when choosing the graft material, as the causative organism was not identified pre-or intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Yamamoto

Igari

Toyofuku

et al. 2017

ATCS

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An arterioenteric fistula is a devastating and life-threatening condition that requires urgent treatment. Less-invasive endovascular treatment has emerged as an alternative to conventional open repair, but postoperative graft infection remains a major concern. We herein report a case of late stent graft infection after emergency endovascular repair of a secondary iliac artery-enteric fistula. The patient was a 63-year-old male who presented with a fever, who had undergone successful endovascular stent grafting for a secondary common iliac artery-enteric fistula 29 months prior. The diagnosis of a stent graft infection was confirmed via computed tomography. He underwent graft removal and in situ reconstruction with femoral vein grafts. At 6-month follow-up, the patient is in a good general condition without any symptoms.

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“…Autogenous SFV grafts have already been utilized successfully in several areas of major venous reconstructions (16). From this experience, it is well known that harvesting the SFV peripherally to the profound femoral vein inflow is well tolerated and associated with only minimal lower extremity venous morbidity, even in the absence of the ipsilateral great saphenous vein (5,16). Apart from these safety aspects, its caliber is larger than that of the external iliac vein, and its length allows at least two interposition grafts to major MHV trunks to be performed using a single SFV.…”

Section: Discussionmentioning

confidence: 99%

“…An extended right lobe including venous drainage by the trunk of the middle hepatic vein (MHV) would guarantee optimal graft function (2). As donor safety represents the paramount concern, the majority of Western groups currently advocate a standard right hemihepatectomy (Couinaud's segments [5][6][7][8] in RL-LDLT, preserving the intact MHV for the donor (3). There is a heated debate about the need to preserve sizable (>5 mm in diameter) MHV tributaries during donor hepatectomy followed by vascular reconstruction using autogenous vein interposition grafts.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Venous Outflow Reconstruction in Right Lobe Living-Donor Liver Graft Using Recipient's Superficial Femoral Vein

Kornberg¹,

Heyne²,

Schotte³

et al. 2003

American Journal of Transplantation

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Venous congestion of a liver graft from a life donor is a disastrous complication with a high risk of graft failure. For safety reasons, the middle hepatic vein (MHV) is currently unanimously left with the donor. As this vessel provides major venous draining of the right anterior sector, reconstruction of significant MHV tributaries is controversial. We describe here successful venous outflow reconstruction in adult-to-adult right lobe livingdonor liver transplantation (RL-LDLT) using the recipient's superficial femoral vein (SFV). Six months after transplantation, graft function and perfusion are excellent, and the patient is free of venous morbidity related to the harvest of the SFV.

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Venous morbidity after superficial femoral-popliteal vein harvest

Cited by 109 publications

References 21 publications

Staged Reconstruction of the Inferior Vena Cava After Gunshot Injury

Staged Reconstruction of the Inferior Vena Cava After Gunshot Injury

Late Stent Graft Infection after the Emergency Endovascular Repair of a Secondary Iliac Artery-Enteric Fistula Treated with Graft Removal and In Situ Aortic Reconstruction Using Femoral Veins

Hepatic Venous Outflow Reconstruction in Right Lobe Living-Donor Liver Graft Using Recipient's Superficial Femoral Vein

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