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INSITU SAPHENOUS VEIN BYPASS GRAFT WITH ANGIOSCOPE FOR VALVECTOMIES IN THE SURGICAL TREATMENT OF CHRONIC ARTERIAL ISCHEMIA OF THE LOWER LIMBS
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Abstract
BACKGROUND: Chronic low-extremity arterial ischemia is a common disease with many causes. While there are many treatments available to these patients, none yield more than modest results. In situ saphenous vein bypass graft with angioscope in which valves are cut under direct visualization is a surgical technique newly available in Vietnam. Although there are many difficulties, preliminary results suggest that the implementation of this technique will improve the management of this disease.
OBJECTIVES: Assessment of preliminary results of in situ saphenous vein bypass graft technique with angioscope.
METHODOLOGY: Prospective and case study. Patients with chronic ischemia of the lower extremity were admitted to the Vascular-Thoracic Unit, 115 people’s Hospital, HCM city.
RESULTS: For nearly 2 years (June 2004 to Sep 2006), at department of General Surgery – 115
People’s Hospital, our Unit received 50 cases with chronic ischemia of the lower extremity, including 26
females and 34 males with the average age 54. The causes of diseases included diabetics (10 cases), arterial sclerotherosis (32 cases) and the others (8 cases). 9 cases were carried out bypass technique in which 3 patients were done with in situ saphenous vein bypass graft with angioscope. The result of 3 patients is good. The ischemia was improved and ulceration at foot was dry and heal.
DISCUSSION: According to D.R. Campbell with more than 1000 cases with good results he has been done in his Unit (USA) and the cases in Binhdan Hospital (2003) and 115 People’s Hospital (2004- 2006) also give good results. The role of International cooperation and between involved specialties in 115 People’s Hospital are the important factors contributing to the success of treatment.
CONCLUSSION: In situ saphenous vein bypass graft with angioscope is a surgical technique which has been applied in many developed countries on the world. It is newly available in Vietnam. Advantages of this technique are less damage to veins and nerves, and disadvantages are equipment, indications, technique and the role of anaesthesia, but with the preliminary results, we think that the implementation of this technique will improve the management of this disease in Vietnam.
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References
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