Superficial femoral—popliteal veins and reversed saphenous veins as primary femoropopliteal bypass grafts: A randomized comparative study Martin L. Schulman,

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Presentation transcript:

Superficial femoral—popliteal veins and reversed saphenous veins as primary femoropopliteal bypass grafts: A randomized comparative study Martin L. Schulman, M.D., Mohan Rao Badhey, M.D., Ruben Yatco, M.D. Journal of Vascular Surgery Volume 6, Issue 1, Pages 1-10 (July 1987) DOI: 10.1067/mva.1987.avs0060001 Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Study structure: reversed saphenous veins vs. superficial femoral—popliteal (SF-P) veins as primary femoropopliteal bypass (FPB) grafts. * = a friable deep femoral—popliteal vein. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Upper left, Flat film shows line of clips applied tangentially (between arrows) to stenose, from 1.2 to 1.0 cm, a widened area in an SF-PV graft. Right, Arteriogram of the same valve-ablated nonreversed graft extending from the deep femoral artery to the distal popliteal artery. Lower left, Detail of insert in film on right illustrates how tantalum clips have been applied to narrow the proximal graft. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Life table of primary patency rates of 56 randomized RSV grafts and 41 randomized SF-PV grafts. Each time interval shows the number and percentage of grafts observed to be patent that length of time. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Life table of secondary patency rates of 56 randomized RSV grafts and 41 randomized SF-PV grafts. Each time interval shows the number and percentage of grafts observed to be patent that length of time. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Life table of primary patency rates of 41 randomized and 24 obligatory SF-PV grafts. Each time interval shows the number and percentage of grafts observed to be patent that length of time. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Life table of limb retention rates for 61 RSV and 65 SF-PV grafts. Each time interval shows the number and percentage of limbs retained that length of time. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 7 Life table of patient survival rates of 61 RSV and 65 SF-PV grafts. In the eight patients with bilateral grafts, each graft was treated as a separate entry. Each time interval shows the number and percentage of patients observed to be alive that length of time. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 8 Ankle circumferences in RSV and SF-PV limbs vs. contralateral unoperated control limbs. Upper numbers represent the number of measurements made and lower numbers indicate average increase in ankle circumference at each time interval. Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 9 Primary and secondary life-table patency rates in the most recent 76 SF-PVs. Primary failures were: 0 to 1 month, two occlusions (judgmental errors); 1 month to 1 year, three occlusions (two black patients with extremely poor runoff and one diabetic smoker, 38 years of age), three percutaneous transluminal angioplasties for distal anastomotic hyperplasia in patients with wide anastomoses, three with wide anastomoses, and following an ill-advised brief period of constructing sharply tapered distal anastomoses, two complete graft bypasses (in situ saphenous veins) and one percutaneous transluminal angioplasty for distal anastomotic hyperplasia; and 3 to 4 years, one complete graft bypass (RSV) for extensive atherosclerosis in a patent graft (“redo”). Journal of Vascular Surgery 1987 6, 1-10DOI: (10.1067/mva.1987.avs0060001) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions