OBJECTIVETo summarize clinical application experience of treatment of occluded iliofemoral veins with great saphenous vein cross-over bypasses.

METHODSFrom September 1998 to December 2005,6 patients(5 men, 1 woman) with occluded iliofemoral veins underwent great saphenous vein cross-over bypasses. They ranged in age from 36 to 52 years (mean, 41 years old). All patients had unilateral thigh and leg edema and swelling with accompanying pain. The normal contralateral great saphenous vein was dissected and it was tunneled across the super-pubic fat pad and anastomosed to the femoral vein or the proximal portion of great saphenous vein in distal to occluded iliofemoral veins.

RESULTSThe postoperative course was uneventful. One case sustained superficial infection postoperatively at donor site and the gradual wound healed by daily wound dressings. At 1 to 3.5 years (mean 1.8 years) followed up, all patients had pain disappearance and obvious relief of the edema but some swelling.

CONCLUSIONGreat saphenous vein cross-over bypasses is effective operative method of treatment of occluded iliofemoral veins. The operation is relatively simple and safe.

Adult ; Embolism ; surgery ; Female ; Femoral Vein ; surgery ; Humans ; Iliac Vein ; surgery ; Male ; Middle Aged ; Saphenous Vein ; transplantation

For the purpose of improving the hemodynamics of CABG, the authors presented a new amelioration measurement of symmetric 2-way bypass graft. The physiological blood flow in 1-way and 2-way bypass graft of coronary is simulated with finite element method, and the data on computational hemodynamics of these two cases were compared. The temporal-spatial distributions of hemodynamics during the cardiac cycle such as flow patterns and wall shear stress in the vicinity of anastomosis were analyzed. The study results showed that 2-way bypass graft was of more rational hemodynamics when compared with 1-way bypass graft, and it could improve the flow conditions and decrease the probability of restenosis.
Anastomosis, Surgical ; Blood Flow Velocity ; Coronary Artery Bypass ; methods ; Coronary Circulation ; Humans ; Saphenous Vein ; transplantation

OBJECTIVETo study the use of vein grafts in adult-to-adult (AA) living donor liver transplantation (LDLT), we transplanted recipient vena saphena magna grafts for drainage of the paramedian portion of the right lobe liver grafts without a middle hepatic vein in LDLT.

METHODSFrom January 2002 to March 2006, 26 patients underwent A-A LDLT, and recipient saphenous vein grafts were used for revascularization of veins and arteries such as: tributaries of the middle hepatic vein from V5, V8; right inferior hepatic vein; injured portal vein; and hepatic artery.

RESULTSTotal outflow reconstruction ratio of V5, V8 and right inferior hepatic vein was 76.9% (20/26), the ratio of one-vein reconstruction was 57.7%, and the ratio of two-vein reconstruction was 19.2%. Reconstruction patterns and cases were demonstrated as follows: V5 (n=3), V8 (n=2), V5 and V8 (n=3), V5 and right inferior hepatic vein (n=1), V8 and right inferior hepatic vein (n=1), right inferior hepatic vein (n=10), injured portal vein of the donor (n=1). Total ratio of hepatic artery bypass grafting was 11.5% (3/26), anastomosis between hepatic artery and abdominal aorta (n=2), and anastomosis between hepatic artery and hepatic artery (n=1). Doppler ultrasound showed no thrombosis and the blood flowed smoothly and without venous outflow obstruction during the 2 to 48 months follow-up period.

CONCLUSIONReconstruction of V5 or V8 outflow and hepatic artery bypass grafting using vena saphena magna of the recipients can provide sufficient venous outflow and prevent the small-for-size syndrome and solve hepatic artery complications. This approach can be recommended.

Adult ; Aged ; Female ; Graft Survival ; Humans ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Saphenous Vein ; transplantation ; Young Adult

BACKGROUND: With increasing coronary bypass and peripheral vascular surgeries, the demand for homologous vascular or synthetic conduits has continued to grow, but wide-spread application has been limited by dismal patency rates. Although cryopreserved allograft valves may provide a suitable alternative, current viability or patency of implanted allograft vascular conduits has been unsatisfactory. MATERIAL AND METHOD: We serially analyzed the outcomes of canine femoral artery and saphenous vein allograft implants after storage in either 4degrees C or -170degrees C. RESULT: There were no differences in graft flow rate (patency) (p=0.264), rate of thrombosis (p=0.264), presence of endothelium (p=0.587), or immunohistochemical staining for thrombomodulin (p=0.657) were detected between grafts stored in 4degrees C and -170degrees C. Greater flow occurred in the arterial grafts versus the venous grafts (p=0.030), irrespective of the preservation method, with a significantly lower incidence of thrombosis (p=0.030) in arterial allografts. There was a correlation coefficient of -0.654 between thrombosis and positive immunohistochemical staining for thrombomodulin (p=0.006) and a correlation coefficient of 0.520 (p=0.0049) between the endothelial presence and positive immunohistochemical staining for thrombomodulin. The relationship between the presence of endothelium and thrombomodulin expression failed to show any correlation within the first 2 weeks (p=0.306). However, a strong correlation was seen after 1 month (p=0.0008). CONCLUSION: Tissue storage in either 4degrees C or -170degrees C in 10% DMSO/RPMI-1640 preservation solution preserved grafts equally well. In terms of thrombosis and graft patency, arterial grafts were superior to venous grafts. Considering the poor correlation between thrombomodulin expression and the presence of an endothelium in the implanted graft within the first two weeks, grafts in this period would not be thromboresistant.
Animals ; Blood Vessel Prosthesis ; Cryopreservation ; Dogs ; Endothelium ; Femoral Artery ; Incidence ; Saphenous Vein ; Thrombomodulin ; Thrombosis ; Transplantation, Homologous ; Transplants

OBJECTIVETo investigate the possibility of using the lesser saphenous vein as the alternative bypass graft in coronary artery bypasss graft (CABG).

METHODSeven pieces of lesser saphenous veins of 6 patients were harvested as the single or sequential grafts of CABG procedure with No-touch technique.

RESULTSThe diameter and length of lesser saphaneous vein met the requirement of graft for entire revascularization. All grafts achieved good flow without significant complications.

CONCLUSIONThe lesser saphenous vein graft is an excellent choice for CABG patient who lacks routine grafts as an alternative material.

Aged ; Coronary Artery Bypass ; methods ; Coronary Artery Disease ; surgery ; Female ; Humans ; Male ; Middle Aged ; Saphenous Vein ; transplantation

Coronary Artery Bypass, Off-Pump ; methods ; Coronary Artery Disease ; surgery ; Humans ; Male ; Middle Aged ; Saphenous Vein ; transplantation

OBJECTIVETo study the substitute portal vein by irradiated allograft saphenous vein during liver transplantation and investigate the changes in morphology and immunology.

METHODSAll the recipients were divided into 3 groups randomly:irradiated allograft group (n = 11) (group A), fresh allograft group (n = 9) (group B) and fresh self-graft group (n = 14) (group C). The number of non-jam graft vessels in each group was explored at 1st week, 2nd week, 1st month, 2nd month and 3rd month post-operation. Also, the infiltration of CD(4)(+), CD(8)(+) T cells and histological changes in grafted vessels were detected.

RESULTSNo obvious histological changes were observed in group A, as well as under naked eyes. There were 9, 3 and 12 non-jam vessels in group A, B and C and there were significant differences between group A and B (P < 0.05). The endothelial cells of graft vessels were observed both in group A and C two weeks post-operation and covered the graft vessels two months later. There were infiltration of lymphocytes and inflammatory cells at early stage, obvious damage and no endothelial cells growth in graft vessels in group B. Compared with group B, the percentage of CD(4)(+), CD(8)(+) T cells in group A was lower significantly, but higher slightly than that in group C.

CONCLUSIONSIrradiated allograft saphenous veins have the quality of ideal vascular transplantation prosthesis and weak antigenicity at the same time. The changes of CD(4)(+), CD(8)(+) T cells after allograft vessels can be detected as immunology index for acute immunological rejection.

Adult ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Graft Rejection ; diagnosis ; Humans ; Liver Transplantation ; Male ; Neutrophil Infiltration ; Saphenous Vein ; immunology ; radiation effects ; transplantation ; Transplantation, Homologous

Iliac vein compression syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis, severe leg edema and ulceration. We experienced a 55-year-old male patient with recurrent left leg ulcer for 15 years. Skin grafting had been done three times, but none of them healed the patient. Femoral venography showed a complete occlusion of the left common iliac vein. Palma-Dale bypass grafting procedure(crossover saphenous vein bypass grafting) and arteriovenous fistula formation was done. The leg ulcer healed two months after the operation.
Arteriovenous Fistula ; Edema ; Humans ; Iliac Artery ; Iliac Vein* ; Leg Ulcer* ; Leg* ; Male ; May-Thurner Syndrome* ; Middle Aged ; Phlebography ; Saphenous Vein ; Skin Transplantation ; Transplants ; Ulcer ; Venous Thrombosis

OBJECTIVETo explore the therapeutic strategy of hot press injury complicating with blood vessel injury in the upper extremity.

METHODSDecompression procedure was carried out in 8 patients with hot press injury complicating with blood vessel injury in the upper extremities, but the effect was not of satisfactory because there were injuries to brachial, radial and ulnar arteries and also injury to the superficial or deep palmar arch. The blood vessels were repaired with direct anastomosis, anastomosis with flexion of the limb, or transplantation with great saphenous vein, and the wounds were covered with intermediate split-thickness skin graft or pedicled thoraco-abdominal skin flap.

RESULTSOne patient with repair of the brachial artery and intermediate split thickness skin graft received amputation 4 weeks after operation because of lack of soft tissue coverage. The blood supply recovered completely in the other patients, so the affected limbs were saved.

CONCLUSIONPrompt exploration and repair of blood vessel, and coverage of the wound with healthy soft tissue are key procedures for the management of hot press injury complicating with blood vessel injury in the upper extremities.

Adolescent ; Adult ; Arm Injuries ; surgery ; Brachial Artery ; injuries ; Burns ; pathology ; surgery ; Crush Syndrome ; surgery ; Decompression, Surgical ; Female ; Humans ; Male ; Saphenous Vein ; transplantation ; Skin Transplantation ; Wound Healing ; Young Adult

The aortic connector system may reduce stroke during proximal venous anastomosis. However, the overall anastomotic patency rate has been generally reported to be low. From October 2002 to March 2004, 68 patients who received proximal anastomosis using the St. Jude Aortic Connector System were included in the study. There were 47 men and 21 women and their mean age was 65.68+/-6.68 yr old (52 to 85 yr). Grafts were evaluated by coronary angiography or multi-slice 16 channel 3-D CT at 6 days and at 6 months postoperatively. In the immediate postoperative period, no stenosis was observed by either angiography (n=22) or 3D CT (n=46). At 6-month postoperatively, we performed either angiography (n=7) or 3-D CT (n=52). Of these patients, 5 patients showed graft stenosis in the midportion, and 3 in the ostium. There were no stroke. Simple, and effective proximal anastomosis with good protection from cerebrovascular accident was achieved especially when calcification or atheromatous plaque was observed at the ascending aorta in the operation room. However, our mid term patency results raise concerns related to venous graft stenosis in the midportion. Therefore, longer follow up is recommended.
Saphenous Vein/*transplantation ; Middle Aged ; Male ; Humans ; Follow-Up Studies ; Female ; Coronary Artery Bypass/*instrumentation ; Aorta/*surgery ; Anastomosis, Surgical/*instrumentation ; Aged, 80 and over ; Aged