Inadequacy of saphenous vein grafts for cross-femoral venous bypass

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Presentation transcript:

Inadequacy of saphenous vein grafts for cross-femoral venous bypass Stephen G. Lalka, MD, Julia M. Lash, PhD, Joseph L. Unthank, PhD, Valerie K. Lalka, RT, Dolores F. Cikrit, MD, Alan P. Sawchuk, MD, Michael C. Dalsing, MD Journal of Vascular Surgery Volume 13, Issue 5, Pages 622-630 (May 1991) DOI: 10.1016/0741-5214(91)90345-U Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Schematic representation of theoretic mathematic model of cross-femoral venous bypass (CFB) for iliac vein obstruction. See Appendix for explanation of abbreviations. Journal of Vascular Surgery 1991 13, 622-630DOI: (10.1016/0741-5214(91)90345-U) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Portion of preobstruction peak common femoral vein flow that would have to be carried by venous collaterals (% flow), despite the presence of a saphenous CFB, to achieve a normal postoperative transfemoral pressure gradient of 4 mm Hg at rest (A) and 6 mm Hg after exercise (B). Bars indicate the number of subjects in each range (n = 18). Journal of Vascular Surgery 1991 13, 622-630DOI: (10.1016/0741-5214(91)90345-U) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Pressure gradient required to drive the resting (A) or after exercise (B) peak common femoral vein flow across a venous collateral network equivalent to a single collateral with a luminal cross-sectional area denoted by the x-axis and a length of 0.14 m (solid line, NO GRAFT). Also illustrated are the effects of implanting a saphenous CFB (mean diameter 4.3 mm; n = 18) or an 8 mm prosthetic CFB in parallel with the collateral network. Journal of Vascular Surgery 1991 13, 622-630DOI: (10.1016/0741-5214(91)90345-U) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 CFB graft diameter (x-axis) required to reduce the preoperative femoral venous pressure gradient (y-axis) to 4 mm Hg at peak resting flows and 6 mm Hg at peak postexercise flows (A). The bars (B) indicate the number of subjects (n = 18) with saphenous vein diameters equal to the corresponding CFB graft diameter. Journal of Vascular Surgery 1991 13, 622-630DOI: (10.1016/0741-5214(91)90345-U) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions