LATE GRAFT FAILURE OF AUTOLOGOUS VEIN GRAFTS FOR ARTERIAL OCCLUSIVE DISEASE - CLINICAL AND EXPERIMENTAL STUDIES

Late graft failure following arterial reconstructive surgery, especial ly after infrainguinal reconstruction, remains a major concern for vas cular surgeons. To more effectively predict the outcome of reconstruct ed arteries, we herein propose an intraoperative Bow waveform analysis which correlates well with the long-term patency rate of grafts. Acco rding to this flow waveform analysis, late graft failure was occasiona lly seen in grafts with type II waveforms when poor distal runoff vess els had been shown by the preoperative arteriogram. Next, to investiga te which events occurring in autologous vein grafts under abnormal hem odynamics may contribute to late graft failure, a distal poor-runoff m odel was made in the canine femoral artery. In this review, we present the results of our investigation on autologous vein grafts using this poor-runoff model. We also relate our recent findings on the function of regenerated endothelium in autologous vein grafts.