Arterialization of great saphenous vein in situ for limb salvation: our clinical experiences

Cvetanovski, Vlatko and Arsovski, Andreja and Brajevic, Liljana and Cvetanovska, Marija and Mitevski, Aleksandar and Kondov, Borislav and Dimitrov, zoran (2021) Arterialization of great saphenous vein in situ for limb salvation: our clinical experiences. Macedonian Medical Review, 75 (2). pp. 60-63. ISSN 0025-1097

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Abstract

Introduction. Critical lower limb ischemia in the absence
of distal arterial circulation presents an urgent
situation, which must be treated immediately if we
want to save the foot or limb from amputation.
Approximately 14%-20% of patients with critical lower
limb ischemia are unsuited for distal arterial reconstruction
and face major distal amputation [1]. Arterialization
of great saphenous vein is a unique procedure in
which the venous bed is used as an alternative conduit
for perfusion of peripheral tissues of lower limb.
Methods. We present our clinical experience in 6
patients who underwent in situ arterialization of great
saphenous vein for treatment of critical below- and
above-knee ischemia.
Maintaining the great saphenous vein in situ allows the
arterialization with one anastomosis without removing
the vein of its original bed. All patients were diagnosed
with color Doppler ultrasound and with CT angiography.
Results. In all 6 patients we managed to safe the limb
or foot from amputation in the first 6 months after the
procedure. Postoperative color Doppler ultrasound was
performed to assess arterial inflow and arterialized
flow in the graft, the anastomosis and venous run-off.
In all patients with significant intraoperative reverse
flow in upper and below the knee part of great saphenous
vein the procedures were initially successful.
Conclusion. Distal revascularization of the limb with
critical ischemia, by creating a reverse flow with in
situ saphenous vein arterialization must be seriously
considered as an attempt for salvage of the foot or
below-knee without distal arterial run-off.
Keywords: arterialization of vein, great saphenous
vein, critical limb ischemia, end-stage peripheral

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Aleksandar Mitevski
Date Deposited:	27 Sep 2023 09:23
Last Modified:	27 Sep 2023 09:23
URI:	https://eprints.ugd.edu.mk/id/eprint/32245

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