SUPERFICIAL FEMORAL VEIN IN ARTERIAL RECONSTRUCTION FOR LIMB SALVAGE - OUTCOME AND FATE OF VENOUS CIRCULATION

Background In some particular cases in vascular surgery it is mandator y to perform arterial reconstruction using autologous graft. Since 198 5, we have been using the superficial femoral vein for arterial substi tute in the case of limb salvage, when another autologous vein has not been available. We made a prospective investigation on 32 patients ov er a mean period of 24.5+/-12.1 months (1 to 48 months) to evaluate th e usefulness of superficial femoral vein (SFV) for distal arterial rec onstructive surgery and to objectify the fate of venous circulation of the Limb after removal of this vein. Methods. There were 20 male and 12 female patients averaging 64.3+/-10.3 years, who underwent crural a rterial reconstructive surgery using the composite technique (PTFE and SFV), AU grafts had been placed subcutaneously in lateral to knee pos ition. Mean length of removed superficial femoral vein was 13.2+/-9.4 cm. Results. In 6 patients (18.7%), we found an early occlusion of byp ass followed by major amputation in 5 cases (15.6%), Minor amputation had to be done in 12 patients (37.5%). Cumulative patency was 56.3% af ter 48 months. Following the removal of superficial femoral vein, we h ad no complications due to venous stasis. We found a significant incre ase of plethysmographically measured venous capacity (1.7+/-0.49 to 2. 51+/-0.71 [p<0.01]) and venous outflow (14.9+/-5.34 to 23.9+/-10.4 [p< 0.05]) after 7.7 months. We did not observe more significant changes o f venous circulation during further follow-up. Conclusions. Despite ov erall good results, we only recommend the use of superficial femoral v ein in hazardous situations, when other autologous material is not ava ilable.