Non-reversed bifurcated vein graft improves time to healing in ischemic patients undergoing lower limb distal bypass.

IF 1.5 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

International Angiology Pub Date : 2023-02-01 DOI:10.23736/S0392-9590.22.04952-5

Nicola Troisi, Daniele Adami, Alberto Piaggesi, Francesco Canovaro, Letizia Pieruzzi, Lorenzo Torri, Mauro Ferrari, Raffaella Berchiolli

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引用次数: 0

Abstract

Background: Bifurcated vein grafts have been described in reconstructive microsurgery. No comparative studies have been published in lower limb arterial revascularization. The aim of this study was to compare non-reversed bifurcated vs. single vein graft in patients with critical limb-threatening ischemia (CLTI) undergoing lower limb distal bypass.

Methods: Between January 2015 and December 2021 193 CLTI patients have been treated at our center with vein bypass, and distal anastomosis on infrapopliteal vessels; 137 patients (71%) received a single graft (Group SIN), and 56 patients (29%) had a bifurcated bypass (Group BIF). Primary outcomes measures were time to healing, primary patency, primary assisted patency, secondary patency, and limb salvage. Two-year outcomes according to Kaplan-Meier curves were evaluated and compared.

Results: Both groups were homogeneous in terms of demographic data, preoperative risk factors, and clinical presentation except for an elderly age in Group BIF (77.5 vs. 71.5 years; P<0.001). Intraoperative technical success was achieved in all patients. Overall median duration of follow-up was 19 months (interquartile range 9-36). Wound healing did not differ between the two groups (77.4% Group SIN vs. 73.2% Group BIF; P=0.33). Mean time to healing was faster in Group BIF (2.4 vs. 6.8 months; P<0.001). At 2-year follow-up there were no differences between the two groups in terms of primary patency (71.4% Group SIN vs. 54% Group BIF; P=0.10), primary assisted patency (81.7% Group SIN vs. 76.4% Group BIF; P=0.53), secondary patency (85.1% Group SIN vs. 80.9% Group BIF; P=0.79), and limb salvage (92.3% Group SIN vs. 87.2% Group BIF; P=0.64).

Conclusions: Bifurcated graft improved time to healing in CLTI patients undergoing infrapopliteal non-reversed vein bypass. Two-year overall patencies and limb salvage did not differ accordingly to vein graft configuration (single vs. bifurcated).

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非逆转分叉静脉移植物可改善下肢远端搭桥缺血患者的愈合时间。

背景:分岔静脉移植物在重建显微外科中已经被描述过。下肢动脉血运重建术的比较研究尚未发表。本研究的目的是比较危重肢体缺血(CLTI)患者行下肢远端旁路手术的非逆转分支静脉移植与单静脉移植。方法:2015年1月至2021年12月，我院对193例CLTI患者行静脉搭桥、远端吻合腘下血管;137例患者(71%)接受了单次移植(SIN组)，56例患者(29%)接受了分流搭桥(BIF组)。主要结局指标为愈合时间、原发性通畅、原发性辅助通畅、继发性通畅和肢体保留。根据Kaplan-Meier曲线评估和比较两年后的预后。结果:两组在人口统计学数据、术前危险因素和临床表现方面均相同，除了BIF组的年龄较大(77.5 vs 71.5岁;结论:分叉移植物改善了行膝下非逆行静脉旁路治疗的CLTI患者的愈合时间。两年的总体通畅度和肢体保留度没有相应的静脉移植配置差异(单静脉vs分静脉)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Angiology 医学-外周血管病

CiteScore

2.80

自引率

28.60%

发文量

审稿时长

6-12 weeks

期刊介绍： International Angiology publishes scientific papers on angiology. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (ICMJE).