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Long Saphenous Vein (long + saphenou_vein)

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Medical Sciences100%

Selected Abstracts

Computed tomography angiographic imaging of the long saphenous vein: diagnostic overkill or a useful advance?

ANZ JOURNAL OF SURGERY, Issue 7 2008
FRACR, Tim Buckenham MB ChB
No abstract is available for this article. [source]

Incomplete cellular depopulation may explain the high failure rate of bovine ureteric grafts

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2008
J. I. Spark
Background: The aim was to assess the results of a decellularized bovine ureter graft (SynerGraft®) for complex venous access. Methods: Bovine ureter conduits were implanted in patients with a failed fistula or access graft in whom native vessels were unsuitable as conduits. Graft histories were obtained from all patients who had undergone this procedure at one institution. Failed grafts were explanted and subjected to histological examination. A sample of fresh bovine ureter was immunostained for galactose (,1 , 3) galactose (,-Gal). Results: Nine patients with a median age of 46 (range 25,70) years underwent complex venous access surgery between August 2004 and November 2006 using a SynerGraft®. Graft types included loop superficial femoral artery to stump of long saphenous vein (four patients), loop brachial artery to vein (two), brachial artery to axillary vein (two) and left axillary artery to innominate vein (one). Three grafts developed aneurysmal dilatation and two thrombosed. Histological assessment of the explanted bovine ureters revealed acute and chronic transmural inflammation. Immunostaining of fresh bovine ureter suggested residual cells and the xenoantigen ,-Gal. Conclusion: Graft failure with aneurysmal dilatation and thrombosis in complex arteriovenous conduits using bovine ureter may be due to residual xenoantigens. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Endovenous laser treatment for long saphenous vein incompetence,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2006
M. A. Sharif
Background: Endovenous laser treatment is a percutaneous technique used for the treatment of long saphenous vein (LSV) incompetence. This paper presents the results of an uncontrolled case series undertaken to assess the feasibility, safety and efficacy of this technique. Methods: Some 145 incompetent LSVs in 136 patients with saphenofemoral reflux were treated with endovenous laser. The data were evaluated prospectively. Assessment was carried out at 1 week, 3 and 12 months for LSV occlusion and symptomatic relief. Results: Primary procedural success was achieved in 124 (85·5 per cent) of 145 LSVs. Reasons for primary failure included failed cannulation, failure to pass the guidewire and patient discomfort. At 3 months' follow-up, 105 (89·7 per cent) of 117 veins were totally and nine (7·7 per cent) were partially occluded. At 12 months, 63 (76 per cent) of 83 veins were totally and 15 (18 per cent) were partially occluded. At this stage 73 (88 per cent) of 83 patients remained satisfied, but 26 (31 per cent) had residual or recurrent varicosities. Of these, only five required further treatment. Complications included saphenous nerve injury in one patient and superficial skin burns in a second. Conclusion: Endovenous laser treatment for LSV reflux is safe and can be carried out under local anaesthesia in an outpatient setting with good patient satisfaction and low complication rates. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Anatomical variation at the saphenofemoral junction,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2005
M. Donnelly
Background: This study was designed to document the surgical anatomy of the saphenofemoral junction (SFJ). Methods: The anatomy of the SFJ was recorded diagrammatically in 2089 consecutive groin dissections performed to treat primary varicose veins. The number of primary tributaries, bifid systems, junctional tributaries and the relationship of the external pudendal artery (EPA) to the long saphenous vein (LSV) were recorded. Results: The LSV was bifid in 18·1 per cent of legs. The number of tributaries at the SFJ varied from one to ten. In 33·4 per cent one or more (junctional) tributaries joined the LSV or common femoral vein deep to the deep fascia. The EPA crossed anterior to 16·8 per cent of LSVs. In 4·6 per cent it passed posterior to one large tributary or trunk of a bifid LSV and anterior to the second trunk, making identification of the second trunk particularly difficult. Conclusion: A thorough understanding of the anatomical variations of the SFJ is important in ensuring that the junction is managed safely and adequately in patients with varicose veins. Failure to appreciate these variations may account for a significant proportion of inadequate primary varicose vein surgery. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Prosthetic femoropopliteal bypass: randomized comparison of polytetrafluoroethylene and heparin-bonded Dacron

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2000
C. Devine
Background: Dacron was largely abandoned for femoropopliteal bypass 30 years ago as saphenous vein achieved better patencies. As patency in prosthetic above-knee (AK) femoropopliteal bypass in patients on aspirin is equivalent to that with saphenous vein, heparin-bonded Dacron (HBD) and polytetrafluoroethylene (PTFE) have been compared in a randomized trial involving ten hospitals which also included below-knee (BK) popliteal or tibioperoneal trunk bypass where the long saphenous vein was absent or inadequate. Methods: Over a 28-month recruitment period, 209 patients undergoing femoropopliteal bypass (180 AK, 29 BK) were randomized by the method of minimization to HBD (n = 106) or PTFE (n = 103). Aspirin 300 mg day,1 was started before surgery and continued unless the patient was intolerant. Results: Mean follow-up was 34 (range 19,48) months. Fifteen patients (7 per cent) died with patent grafts and three (1 per cent) infected grafts were removed. Patency (measured by Kaplan,Meier survival analysis) was 70, 63 and 55 per cent at 1, 2 and 3 years for HBD, compared with 56, 46 and 42 per cent respectively for PTFE (P = 0·0444). Patency at 3 years for AK bypass was significantly better than that for BK bypass. A total of 70 interventions were performed on 47 patients, achieving long-term patency in only three. Amputations were performed in 23 patients, six with HBD and 17 with PTFE grafts (P = 0·015, Fisher's exact test). Conclusion: In femoropopliteal bypass, primary patency was better with HBD than PTFE, and HBD was associated with a lower amputation rate. © 2000 British Journal of Surgery Society Ltd [source]

Staged in situ bypass

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2000
T. A. Ojimba
Background: After femoral revascularization, following embolectomy or proximal reconstruction, the need for additional distal revascularization may be unpredictable. This dilemma may be addressed by anastomosing the detached upper end of the long saphenous vein to the femoral arteriotomy, as for in situ bypass, permitting some outflow into proximal vein tributaries. Later, if ischaemia persists, distal arterial flow can be established by closed retrograde saphenous valvulotomy. Methods: Over 12 years this technique was employed in 26 legs in 22 patients, following inflow reconstruction in 15 and femoral embolectomy in seven. Postoperative observation showed persisting distal ischaemia in 14 legs and distal bypass was completed after 1,9 days, using local anaesthesia without femoral re-exposure. One patient died at 15 days and 13 grafts were patent on discharge from hospital. Results: In 12 legs in 11 patients, limb perfusion was deemed adequate after operation. Four patients (five legs) died in hospital and seven were discharged. No further procedure was required in five and the proximal long saphenous vein presumably thrombosed. In two legs the whole long saphenous system had become pulsatile at 7 and 8 months, and a distal bypass was completed. No amputations were required in this series. Conclusion: Staged in situ bypass can avoid prolonged and complex reconstructions in frail patients and facilitates the use of local anaesthesia, where necessary. © 2000 British Journal of Surgery Society Ltd [source]

Lower limb ulceration: a detailed study of aetiology in 555 patients

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2000
J. Naik
Background: The purpose of the study was to investigate the aetiology of lower limb ulceration. Methods: The aetiology of lower limb ulceration was reviewed in 555 patients with 689 ulcerated limbs referred to a single-visit leg ulcer clinic. Results: The mean age of the patients was 70 (range 27,95) years and 335 (60 per cent) were women. The aetiology of the ulceration in 689 limbs was venous in 496 (72 per cent), arterial in 14 (2 per cent), mixed venous and arterial in 101 (15 per cent), with other causes in 78 (11 per cent). Of the 496 venous ulcers, 261 (53 per cent) had isolated superficial reflux, 233 (47 per cent) had deep venous reflux, of which 165 (71 per cent) had full-length and 68 (29 per cent) segmental reflux, and two patients had isolated perforator reflux. Deep venous obstruction was present in 16 limbs (3 per cent) with venous ulcers and 14 of these demonstrated continuous flow in the long saphenous vein (LSV). Of the 261 ulcerated legs with isolated superficial reflux, 197 (75 per cent) had LSV reflux only, 22 (8 per cent) had short saphenous vein (SSV) reflux only and 41 (16 per cent) had combined LSV and SSV reflux. Of those with LSV reflux, 65 per cent had a medial malleolar ulcer and 20 per cent had a lateral malleolar lesion. Of those with SSV reflux, 62 per cent had a lateral malleolar ulcer and 38 per cent had a medial malleolar ulcer. Conclusion: Half of the ulcerated legs have superficial venous reflux; these combined with the superficial and segmental deep venous reflux group comprise the 65 per cent of patients who may benefit from superficial venous surgery. Continuous flow in the LSV should alert the clinician to deep venous obstruction, in which circumstance compression therapy should be used with extreme caution. Duplex is central to the investigation of the ulcerated leg. © 2000 British Journal of Surgery Society Ltd [source]