Publication details
ALTERNATIVE AUTOLOGOUS VEIN GRAFTS VERSUS SINGLE SEGMENT GREAT SAPHENOUS VEIN IN LOWER EXTREMITY BYPASS SURGERY - SINGLE-CENTER STUDY
| Authors | |
|---|---|
| Year of publication | 2025 |
| Type | Article in Periodical |
| Magazine / Source | Annals of Vascular Surgery |
| MU Faculty or unit | |
| Citation | |
| web | https://www.sciencedirect.com/science/article/pii/S0890509625000548?CMX_ID=&SIS_ID=&dgcid=STMJ_219742_AUTH_SERV_PA&utm_acid=129676833&utm_campaign=STMJ_219742_AUTH_SERV_PA&utm_in=DM539090&utm_medium=email&utm_source=AC_ |
| Doi | http://dx.doi.org/10.1016/j.avsg.2025.01.027 |
| Description | Objectives Studies comparing alternative autologous vein grafts (AAVG) to single-segment great saphenous vein (ssGSV) grafts report mixed results. The status of AAVG as first choice when ssGSV is unavailable is not unequivocal, based on current evidence. Our study compares results between AAVG and ssGSV in lower extremity bypass surgery. Methods A single-center retrospective cohort study involving all patients who underwent infrainguinal bypass using AAVG (arm veins, spliced arm or arm-leg veins) and ssGSV, April 2019-June 2023. Study endpoints were patency rates and amputation-free survival (AFS). Results There were 65 (20.8%) patients in the AAVG group, 247 (79.2%) in the ssGSV group. Chronic Limb-Threatening Ischemia (CLTI) was the most frequent indication for surgery (AAVG 54/65, 83.1% vs. ssGSV 170/247, 68.8%), followed by acute limb ischemia (AAVG 6/65, 9.2% vs. ssGSV 28/247, 11.3%); claudicants presented only in ssGSV group (AAVG 0/65, 0% vs. ssGSV 44/247, 17.8%). More re-do operations occurred in AAVG than ssGSV group (23/65, 35.4% vs. 26/247, 10.5%;p<.001). Spliced-vein grafts represented 87.7% (57/65) of AAVG bypasses. Median follow-up was 20.1 months for AAVG group, 27.5 for ssGSV group. Three-year patency rates between AAVG vs. ssGSV: primary 59.3%±8.2% vs. 69.2%± 3.8%,p=.113; primary assisted 75.2%±7.1% vs. 73.5%±3.4%,p =.790; secondary 74.9%±7.1% vs. 74.4%± 3.4%,p=.667; did not display significant difference between groups, nor did 3-year AFS in CLTI patients; 70.7%±7.9% vs. 54.6%±4.8%;p=.273. Conclusions Alternative autologous vein grafts should be the first conduit choice when single-segment great saphenous vein is unavailable. Mid-term patency rates do not differ from those of ssGSV grafts despite higher reintervention rate. |