THE RESULTS OF ANGIOSCOPY ON ARM VEINS AND THEIR EFFECTS ON THE USAGE OF ARM VEINS AS INFRAINGUINAL BYPASS MATERIAL

The possibility of the usage of the autologue vein mate;ial in distal bypass surgery is decreasing more and more be­ cause of Femoro-distal reconstructions and the increases in Coronary revascularisations. Arm veins are more often being used as autologue bypass material due to these causes.

in this study, the results of endoscopic examinations of arm veins (136 segments) which have been used as bypass material in Femoro-distal bypass surgery (n=67) between 01/94 • 08/99 have been prospectively examined. Veins with diameters bigger than 2.5 mm have been used as bypass material. Among 136 vein segments examined, 43 pa­ tological endoluminal abnormalities have been diagnosed. Web (n=28), thrombus (n=6), vein sclerosis/stenosis (n=9). The patological endoluminal abnormalities have been diagnosed in the lower arm are as 41.4 % in the Cep­ halic vein , 33.3 % in the Basilic vein, and 46.6 % in the Cubital vein; in the upper arm as 28.8 % in C-:: :•,alic vei n, 18.8 % in the Basilic vein. it has been possible to repair a big number of these endoluminal abnormalities with the manipulations accompanied by angioscopy (excision (12), patchplasty (4), thrombectomy (5), web resection (21)). in these bypı=.ıss reconstructions, veno-venostomy has been avoided as much as possible. The median of the segments used per reconstruction is 2.3. The transplant materials have mostly been reversedly implanted. 86.8 % of the re­ constructions were crural or pedal reconstructions.

It is possible for the armveins to be used in Femoro-crural reconstructions as a routin autologue bypass material. An­ gioscopy presents valuable information about the quality of the vein segment to be used; and the results of the re­ constructions made by relying on !his information prove the importance of endoscopy.