Journal «Angiology and Vascular Surgery» • 

2010 • VOLUME 16 • №1

USE OF PRELIMINARILY PREPARED V. CEPHALICA IN OPERATIONS OF FEMORAL-DISTAL BYPASS GRAFTING

Alukhanyan O.A., Martirosyan Kh.G., Aristov D.S.
Chair of Angiology, Ambulatory and Vascular Surgery of the Advanced Medical Training Department, Kuban State Medical University,
Krasnodar, Russia

Presented herein is the authors’ experience in using a preliminarily prepared lateral subcutaneous vein of the arm (v.cephalica) for femoral-distal reconstructions in a total of nine patients with lower-limb critical ischaemia (LLCI). The choice of the vein referred to above as a bypass graft was a forced one because of a loose-type, insufficient-diameter greater saphenous vein (GSV), varicose and postphlebitic alterations therein or merely the total lack thereof after previous phlebectomy, with such a decision also influenced by no adequate lesser saphenous vein (LSV) available. Given the anticipated level of the would-be distal anastomoses, utilizing synthetic prosthetic grafts of blood vessels seemed fterly undesirable, and immediately employing upper-limb veins as bypass grafts turned out virtually impossible owing to their small diameter.

The preparation of the bypass graft consisted in first forming a fistula between the radial artery and v.cephalica in the lower third of the forearm. The procedure involving a 2-to-3-week functioning of the fistula and the so-called «training», of the vein according to a specially devised technique was followed by a noticeable widening of the lumen of the v. cephalica, thus allowing us in the long run to successfully use it for femoral-distal reconstructions.

KEY WORDS: lower-limb critical ischaernia, femoral-distal bypass grafting, arteriovenous fistula.

P. 114-118

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