Summary
An experiment was undertaken to examine the effect on blood flow and patency in vein by-pass grafts of inflow and outflow restriction by critical stencsis proximal or distal to the graft.
A total of 50 experimental canine femoral artery by-pass vein grafts were performed, 25 in each group. Flow was measured with an electromagnetlc flowmeter. The animals were arranged according to flow ranges achieved. There were four subgroups in the outflow restriction group. None of 15 grafts with mean flow below 60mls/min. were classified as successful. Ten grafts out of ten with flows in excess of 60mls/min. were patent when examined at four weeks. None of the 25 grafts subjected to an Inflow reduction were patent at four weeks although five had mean flows between 60 and 80mls/min. and five had flows of 80mls/min, or greater.
It is concluded that (1) if proximal aorto-iliac disease can be positively outruled, mean flow levels measured intraoperatively are a reliable prognostic indicator of early vein graft patency in the femoro-popliteal segment, and (2) femcro-popliteal arterial reconstruction will fail if performed in the presence of undetected aorta-iliac disease.
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References
Barner, H. B., Judd, D. R., Kaiser, G. C., Willman, V. L., Hanlon, C. R. 1968. Blood flow in femoro-popliteal by-pass grafts. Arch. Surg. 96, 519.
Bernhard, V. M., Kayser, G., Gutierrez, J., Ellison, E. H. 1968. Salvage of ischaemic limb. J. Amer. med. Assn. 204, 234.
Cannon, J. A., Lopresis, E. L., Van der Berg, L. 1960. Experience with a new electromagnetic flowmeter for use in blood flow determinations in surgery. Ann. Surg. 152, 635.
Friedman, S. A., Hollins, H. E., Brook, R. 1964. Etiologic factors in aorto-iliac and femoropopliteal vasoular disease. N. Eng. J. Med. 271, 1382.
Little, J. M., Sheil, A. G. R., Lowenthal, J., Goodman, A. 1968. Prognostic value of intra-operative blood flow measurement in femoropopliteal by-pass grafts. Lancet ii, 648.
May, A. G., Vander Berg, L., De Weese, J. A., Robb, C. G. 1963. Critical arterial stenosis. Surgery, 54, 250.
Moore, W. S., Hall, A. D. 1971. Unrecognised aorto-iliac disease. Arch. Surg. 103, 633.
Morton, D. L., Ehrendeld, W. K., Wylie, E. J. 1967. Signlficance of outflow obstruction after femoropopliteal endarterectomy. Arch. Surg. 94, 592.
Mundth, E. D., Darling, R. C., Linton, R. R., Ruckley, M. J., Austen, W. G. 1969. Qualitative and correlation of distal arterial outflow and patency of femoropopliteal reversed saphenous vein grafts with intra-operative flow and pressure measurements. Surgery, 60, 197.
Terry, H. J., Allan, J. S., Taylor, G. W. 1972. The relationship between blood flow and failure of femoropopliteal reconstructive surgery. Brit. J. Surg. 59, 549.
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Bouchier-Hayes, D., FitzGerald, P.A.M. The influence of proximal stenosis, distal stenosis and mean blood flow on the early patency of vein by-pass grafts an experimental study. Ir J Med Sci 146, 15–19 (1977). https://doi.org/10.1007/BF03030921
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DOI: https://doi.org/10.1007/BF03030921