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Article
April 1992

Mesh Tube—Constricted Varicose Veins Used as Bypass Grafts for Infrainguinal Arterial Reconstruction

Author Affiliations

From the Second University Surgery Clinic (Drs Moritz, Grabenwöger, Raderer, Staudacher, Magometschnigg, and Wolner), and the Department of Pathology (Dr Ullrich), University of Vienna (Austria); and the Department of Cardiovascular and Thoracic Surgery, Hospital of the Sisters of Mercy, Wels (Austria) (Dr Ptakovsky).

Arch Surg. 1992;127(4):416-420. doi:10.1001/archsurg.1992.01420040058010
Abstract

• Varicose veins are generally deemed inappropriate graft material for arterial reconstructions despite their physiologic flow surface because of their large and irregular caliber. Size reduction by threading such veins in constricting tubes may create bypass grafts of suitable caliber as long as redundant wall material does not cause stenoses. Sixteen human varicose veins (mean±SD,13±3 mm diameter) obtained after stripping operations were inserted into Dacron mesh tubes of 6 mm internal diameter. Paraffin casts of the distended veins showed a size reduction of 6.9±2.6 mm. Wall material formed folds in only two veins. In both cases, diameter reduction was more than 10 mm. However, the folds did not result in significant stenoses. Mesh-constricted varicose veins were used as bypass material in 11 infrainguinal arterial reconstructions. All externally supported segments showed satisfactory size reduction without stenoses or folds. One graft occluded 2 months after surgery. Two patients had to undergo reoperation after 2 and 16 months, respectively. None of the complications could be attributed to the constriction of veins. The remaining grafts are patent and functional after a mean of 17 months (range, 6 to 42 months). Considerable size reduction by external wrapping of varicose veins is possible without adverse side effects. Such constricted veins were used successfully as bypass grafts for infrainguinal arterial reconstructions.

(Arch Surg. 1992;127:416-420)

References
1.
Deriu GP, Baöotta E, Bonavina L, et al.  Great saphenous vein protection in arterial reconstructive surgery . Eur J Vasc Surg . 1986;3:253-260.Article
2.
Barra JA, Volant A, Leroy JP, et al.  Constrictive perivenous mesh prosthesis for preservation of vein integrity . J Thorac Cardiovasc Surg . 1986;92:330-336.
3.
Karayannacos PE, Hostetler JR, Bond MG, et al.  Late failure in vein grafts: mediating factors in subendothelial fibromuscular hyperplasia . Ann Surg . 1978;187:183-188.Article
4.
Kohler TR, Kirkman TR, Clowes AW.  The effect of rigid external support on vein graft adaptation to the arterial circulation . J Vasc Surg . 1989;9:277-285.Article
5.
LoGerfo FW, Haudenschild CC, Quist WC.  A clinical technique for preservation of spasm and preservation of endothelium in saphenous vein grafts . Arch Surg . 1984;119:1212-1214.Article
6.
Veith FJ, Gupta SK, Ascer E, et al.  Six year prospective multicenter randomized comparison of autologous saphenous vein and expanded polytetrafluoroethylene grafts in infrainguinal arterial reconstructions . J Vasc Surg . 1986;3:104-114.Article
7.
Sapsford RN, Oakley GD, Talbot S.  Early patency of expanded polytetrafluoroethylene vascular grafts in aorto-coronary bypass . J Thorac Cardiovasc Surg . 1981;81:860-864.
8.
Brookbank KGM, Donovan TJ, Ruby ST, Carpenter JF, Hagen PO, Woodley MA.  Functional analysis of cryopreserved veins . J Vasc Surg . 1990;11:94-102.Article
9.
Morinaga K, Eguchi H, Miyazaki T, Okadome K, Sugimachi K.  Development and regression of intimal thickening of arterially transplanted autologous vein grafts in dogs . J Vasc Surg . 1987;5:719-730.Article
10.
Morinaga K, Okadome K, Kuroki M, Miyazaki T, Muto Y, Inokuchi K.  Effect of wall shear stress on intimal thickening of arterially transplanted veins in dogs . J Vasc Surg . 1985;2:430-433.Article
11.
Berguer R, Higgins RF, Reddy DJ.  Intimal hyperplasia . Arch Surg . 1980;115:332-335.Article
12.
Dobrin PB, Littooy FN, Endean ED.  Mechanical factors predisposing to intimal hyperplasia and medical thickening in autogenous vein grafts . Surgery . 1989;105:393-400.
13.
Rusenblum WI, El-Sabban F.  Influence of shear rate on platelet aggregation in cerebral microvessels . Microvasc Res . 1982;23:311-315.Article
14.
Madras PN, Ward CA, Johnson WR, Singh PI.  Anastomotic hyperplasia . Surgery . 1981;90:922-923.
15.
Walden R, L'Italien GJ, Megerman J, Abbott WM.  Matched elastic properties and successful arterial grafting . Arch Surg . 1980;115:1166-1169.Article
16.
Harris RW, Andros G, Dulawa LB, Oblath RW, Salles-Cunha SX, Apyan R.  Successful long term limb salvage using cephalic vein bypass grafts . Ann Surg . 1984;200:785-792.Article
17.
Stoney WS, Alford WC, Burrus GR, Glassford DM, Petracec MR, Thomas CS.  The fate of arm veins used for aorto-coronary bypass grafts . J Thorac Cardiovasc Surg . 1984;88:522-526.
18.
Schulman ML, Badhey MR, Yatco R, Pillari G.  A saphenous alternative: preferential use of superficial femoral and popliteal vein as femoropopliteal bypass grafts . Am J Surg . 1986;152:231-237.Article
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