PMID: 20635725Jul 20, 2010Paper

Use of preliminarily prepared v. cephalica in operations of femoral-distal bypass grafting

Angiologii︠a︡ i sosudistai︠a︡ khirurgii︠a︡ = Angiology and vascular surgery
O A AlukhanianD S Aristov

Abstract

Presented herein is the authors'experience in using a preliminarily prepared lateral subcutaneous vein of the arm (v. cephalica) for femoral-distal reconstructions in a total of nine patients with lower-limb critical ischaemia (LLCI). The choice of the vein referred to above as a bypass graft was a forced one because of a loose-type, insufficient-diameter greater saphenous vein (GSV), varicose and postphlebitic alterations therein or merely the total lack thereof after previous phlebectomy, with such a decision also influenced by no adequate lesser saphenous vein (LSV) available. Given the anticipated level of the would-be distal anastomoses, utilizing synthetic prosthetic grafts of blood vessels seemed fterly undesirable, and immediately employing upper-limb veins as bypass grafts turned out virtually impossible owing to their small diameter. The preparation of the bypass graft consisted in first forming a fistula between the radial artery and v.cephalica in the lower third of the forearm. Theprocedure involvinga 2-to-3-week functioning of the fistula and the so-called "training", of the vein according to a specially devised technique was followed by a noticeable widening of the lumen of the v. cephalica, thus allowing us in t...Continue Reading

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