A Technique for Prolonged Arterial Infusions of Fibrinolytic Agents in the Immediate Postoperative Period through a Cutaneous Venostomy

Abstract

Prolonged use of fibrinolytic agents post thrombectomy is limited by present techniques that require arterial puncture and indwelling arterial catheters. This limitation can be avoided by attaching a short segment of saphenous vein to the arteriotomy used for the thrombectomy and bringing this out to the skin as a “venostomy”; thus providing ready access to the vascular tree for arteriography, prolonged infusion of thrombolytic agents, or selective catheter placement. In delayed thrombectomies (Categories 2 & 3 as described by the Ad Hoc Committee on Reporting Standards, J Vasc Surg 1986;4:80-94), extending the use of these agents may represent the only hope for limb salvage. (Ann Vasc Surg 1997;11:546–549.)