Peripheral vascular reconstruction using deep vein graft for critically ill patients

Abstract

The great saphenous veins are gaining wide popularity as acceptable native vascular grafts, but in terms of flow capacity, their small caliber may be unsuitable for immediate replacement of arterial flow. Ten peripheral vascular or central venous reconstructions were performed using superficial femoral vein free grafts for re-establishment of immediate high-flow patency. Seven of the patients were men with a mean age of 61.5 ± 17.9 years (range, 21–81 years). The majority of the patients were of preoperative or intraoperative critically ill statuses in that they had extensive infection (n = 5), bleeding (n = 4), renal failure (n = 3) or hepatic failure (n = 1). The mean preoperative physiology score of the vascular POSSUM was 24.1 ± 8.8 (range, 15–37), and the mean operative severity score was 18.4 ± 4.9 (range, 10–26). All patients survived and recovered from systemic infection or critical hemodynamic instability. During the mean 28.9 months of follow-up, complications such as aneurysmal dilation, recurrent infection, graft stenosis/occlusion, lower limb edema and other clinical problems that required attention were not observed. In conclusion, we determined that deep veins can be applied as ideal graft conduits for reconstructing the major peripheral vessels under complicated conditions in select patients.