The results of in situ saphenous vein bypass for infrainguinal arterial reconstruction: Comparison between two types of valvulotomes

Abstract

PURPOSE: To evaluate the authors' experiences with in situ saphenous vein bypasses that were performed using two types of valvulotomes and to respectively compare their efficacy on the basis of the operative outcomes.

METHODS: Between June 1993 and December 2008, 103 constructive in situ saphenous vein bypasses were performed, of which 53 were performed between 1993 and 2000 using an Insitucat valvulotome (B Braun Melsungen AG, Germany), and 50 were performed between 2000 and 2008 using a LeMaitre valvulotome (LeMaitre Vascular Inc, USA).

RESULTS: There were no statistical differences with regard to age, sex and bypass procedures between the two groups. Critical limb ischemia (P=0.021) and diabetes (P=0.005) were more frequent in the LeMaitre group than the Insitucat group. Intraoperative graft revisions (P=0.079) and graft spasms (P=0.638) were less frequent in the LeMaitre group. Graft failures in the perioperative period or within the first year were less frequent in the LeMaitre group. The five-year cumulative primary patency rates were 63.2% and 59.8% in the LeMaitre and Insitucat groups, respectively (χ²=0.390, not significant). The five-year cumulative secondary patency rates were 91.9% and 81.7% in the LeMaitre and Insitucat groups, respectively (χ²=2.690, not significant).

CONCLUSIONS: The results suggested that there were no significant differences in the outcome and adverse effects between the two types of valvulotomes for in situ saphenous vein bypass.