Autogenous Vein Graft for Repair of Acute Tibial Artery Injury

Purpose: The patients with major vascular injuries in the traumatized extremity and underwent arterial reconstruction using autogenous vein grafts for limb salvage. This study aims to report the outcomes of arterial reconstruction with autogenous vein graft in patients.Methods: From February 2015 to April 2017, a study was retrospectively analyzed 13 patients with limb injuries caused by significant arterial damage and underwent arterial reconstruction using vascular autografts for limb salvage. Such as cause, Mangled Extremity Severity Scores (MESS), ischemic time, length of the grafted vein, reconstructed arterial status, and survival status were analyzed. Results: Among the patients analyzed, nine patients’ injuries were caused by traffic accidents and three industrial accidents, one fall down. Mean MESS was 6.2 (range, 5–8) and mean ischemic time was 12.3 hours (range, 5–25 hours). As arterial reconstruction, seven patients underwent posterior tibial artery reconstruction, three underwent popliteal artery reconstruction, two underwent anterior tibial artery reconstruction, and one underwent radial artery reconstruction; the greater saphenous vein was grafted in 12 reconstruction cases. Mean length of the grafted vein was 4.9 cm (range, 3–10 cm). All patients have salvaged injured limbs.Conclusion: Artery reconstruction using autogenous vein graft is an efficient treatment method when vascular damage cannot be directly repaired during limb salvage.

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The effect of a distal arteriovenous fistula upon an autogenous vein graft in the venous system

Journal of Surgical Research ◽

10.1016/s0022-4804(63)80068-2 ◽

1963 ◽

Vol 3 (8) ◽

pp. 412-415 ◽

Cited By ~ 14

Author(s):

Carl A. Smith ◽

Richard M. Schisgall

Keyword(s):

Arteriovenous Fistula ◽

Vein Graft ◽

Venous System ◽

Autogenous Vein

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FREE AUTOGENOUS VEIN GRAFT TO THE INTERNAL AND COMMON CAROTID ARTERIES IN THE TREATMENT OF TUMORS OF THE NECK

Annals of Surgery ◽

10.1097/00000658-195302000-00009 ◽

1953 ◽

Vol 137 (2) ◽

pp. 205-214 ◽

Cited By ~ 52

Author(s):

John J. Conley

Keyword(s):

Vein Graft ◽

Carotid Arteries ◽

Autogenous Vein ◽

Common Carotid Arteries

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Posterior Tibial Artery Injury with Intact Posterior Tibial Pulse: A Case Report

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2018/34921.11881 ◽

2018 ◽

Author(s):

Kamalakumar Karuppasamy ◽

Natarajan Shanmugam ◽

Gunalan Kannaiyya Naidu ◽

Surya Rao Rao Venkata Mahipathy ◽

Narayanamurthy Sundaramurthy

Keyword(s):

Case Report ◽

Posterior Tibial Artery ◽

Posterior Tibial ◽

Artery Injury ◽

Tibial Artery

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Massive hematuria due to an autogenous saphenous vein graft and urinary bladder fistula in an extra-anatomic iliofemoral bypass: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-019-2300-8 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 1

Author(s):

Luan Jaha ◽

Vlora Ismaili-Jaha ◽

Bekim Ademi ◽

Fahredin Veselaj ◽

Destan Kryeziu ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Bladder ◽

Reconstructive Surgery ◽

Vein Graft ◽

Saphenous Vein Graft ◽

Pelvic Surgery ◽

Proximal Anastomosis ◽

Oncologic Surgery ◽

Anastomotic Pseudoaneurysm ◽

Autogenous Vein

Abstract Introduction Gross hematuria caused by rupture of an artery in the urinary tract is a rare but potentially fatal condition. Iliac artery aneurysms, pelvic surgery with radiation, vascular reconstructive surgery, surgery for stenosis of the ureteropelvic junction, and transplantation are reported to be associated with this condition. In the vascular reconstructive surgery group, the most common etiology is rupture of the degenerated artery or synthetic graft in the ureter. Case presentation We present a case of rupture of the small anastomotic pseudoaneurysm at the proximal anastomosis of a right iliofemoral autogenous vein extra-anatomic graft in the urinary bladder. To our knowledge, this is the first report of a rupture of an autogenous vein graft in the urinary bladder. Our patient, a 24-year-old Albanian farmer, was admitted to the emergency department in severe hemorrhagic shock induced by exsanguinating hematuria. He underwent immediate surgery, during which direct sutures to the bladder were placed and the saphenous graft was replaced with a synthetic one. The patient recovered completely, was free of hematuria, and showed no signs of pathological communication between the urinary and arterial tracts on postoperative cystoscopy and computed tomographic angiography during 2 years of follow-up. Conclusion The incidence of artery-to-urinary tract fistulas is growing due to the increasing use of urologic and vascular surgery, pelvic oncologic surgery, and radiation therapy. In addition to fistulas involving a degenerated artery and ureter or synthetic grafts and ureter, they can also involve an autogenous vein graft and the urinary bladder. In our patient, the fistula was a result of erosion of the bladder from a pseudoaneurysm at the proximal anastomosis of an autogenous vein iliofemoral bypass in an extra-anatomic position. Open surgery remains the best treatment option, although there is increasing evidence of successful endovascular treatment.

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Comparison of propaten heparin-bonded vascular graft with distal anastomotic patch versus autogenous saphenous vein graft in tibial artery bypass

Vascular ◽

10.1177/1708538117717141 ◽

2017 ◽

Vol 26 (2) ◽

pp. 117-125 ◽

Cited By ~ 3

Author(s):

Jeremy Kaisar ◽

Aaron Chen ◽

Mathew Cheung ◽

Elias Kfoury ◽

Carlos F Bechara ◽

...

Keyword(s):

Limb Salvage ◽

Saphenous Vein ◽

Vein Graft ◽

Saphenous Vein Graft ◽

Artery Bypass ◽

Length Of Hospital Stay ◽

Primary Patency ◽

Secondary Patency ◽

Graft Occlusion ◽

Tibial Artery

Introduction Heparin-bonded expanded polytetrafluoroethylene grafts (Propaten, WL Gore, Flagstaff, AZ, USA) have been shown to have superior patency compared to standard prosthetic grafts in leg bypass. This study analyzed the outcomes of Propaten grafts with distal anastomotic patch versus autogenous saphenous vein grafts in tibial artery bypass. Methods A retrospective analysis of prospective collected data was performed during a recent 15-year period. Sixty-two Propaten bypass grafts with distal anastomotic patch (Propaten group) were compared with 46 saphenous vein graft (vein group). Pertinent clinical variables including graft patency and limb salvage were analyzed. Results Both groups had similar clinical risk factors, bypass indications, and target vessel for tibial artery anastomoses. Decreased trends of operative time (196 ± 34 min vs. 287 ± 65 min, p = 0.07) and length of hospital stay (5.2 ± 2.3 days vs. 7.5 ± 3.6, p = 0.08) were noted in the Propaten group compared to the vein group. Similar primary patency rates were noted at four years between the Propaten and vein groups (85%, 71%, 64%, and 57%, vs. 87%, 78%, 67%, and 61% respectively; p = 0.97). Both groups had comparable secondary patency rates yearly in four years (the Propaten group: 84%, 76%, 74%, and 67%, respectively; the vein group: 88%, 79%, 76%, and 72%, respectively; p = 0.94). The limb salvage rates were equivalent between the Propaten and vein group at four years (84% vs. 92%, p = 0.89). Multivariate analysis showed active tobacco usage and poor run-off score as predictors for graft occlusion. Conclusions Propaten grafts with distal anastomotic patch have similar clinical outcomes compared to the saphenous vein graft in tibial artery bypass. Our data support the use of Propaten graft with distal anastomotic patch as a viable conduit of choice in patients undergoing tibial artery bypass.

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