A. Alback et al., Valvulotomy of non-reversed saphenous vein bypass grafts: a randomised, blinded, angioscopy-controlled study, EUR J VAS E, 18(2), 1999, pp. 144-148
Citations number
29
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Objectives: to compare the result of vein valve disruption with two differe
nt valvulotomes during non-reversed saphenous vein bypass.
Design: a randomised, blinded clinical study.
Materials and methods: twenty patients undergoing femorodistal non-reversed
saphenous vein arterial bypass were randomised into two equal groups. Valv
e leafier disruption tons performed either with a standard size plastic val
vulotome or with a metal valvulotome with an exchangeable cutting head. Val
vulotomy was done after full exposure of the vein and completion of the pro
ximal anastomosis. The result was evaluated by a surgeon blinded to the val
vulotome used, using angioscopy.
Results: a total of 219 valve cusps were inspected with angioscopy. There w
ere 83 completely lysed cusps (69%) by plastic and 76 (78%) by metallic val
vulotomes (p=0.14). Of all the incompletely lysed cusps 22 (29%) occurred i
n the most proximal valve pocket treated with valvulotomy.
Conclusions: no significant difference in performance between the investiga
ted valvulotomes was found. Incomplete valvulotomy occurred mainly in rile
proximal part of the vein and was obviously caused by a size mismatch betwe
en the diameter of vein and the valvulotome. Construction of a valvulotome
with a variable diameter cutting head is therefore recommended.