Femoro-popliteal reconstructions: "insitu" versus "reversed" technique: comparative results

Introduction. Infrainguinal arterial reconstruction is a procedure with two main types of autologous venous grafts: reversed-vein bypass grafting, and the in situ bypass grafting. Both techniques have advantages and disadvantages, and the aim of this study was to compare the results of each technique. Material and methods. In the period from 1999 to 2003, 118 patients with infrainguinal arterial occlusive disease (IAOD) undenvent reconstruction surgery at the Vascular and Transplantation Surgery Clinic in Novi Sad. 141 reconstruction procedures were performed using the autologous great saphenous vein. The patients were divided into two groups: group I included 72 patients with "in situ " by?pass grafts and group II included 46 with 55 "reversed" bypass grafts. The postoperative function was evaluated by using a pocket-sized Doppler sonography, and by assessment of the postoperative increase in API in regard to preoperative values. Results. Statistical analysis of the investigated groups of patients and X2 showed that there were no statistically significant differences in postoperative patency, complication rate and number of salvaged limbs. Conclusion. We can conclude that both investigated reconstruction techniques have advantages and minor disadvantages: they are applicable, safe and reliable and each has a specific range of indications. . Danas se kod rekonstruktivnih procedura na infraingvinalnom segmentu arterijskog stabla ravnopravno upotrebljavaju dve vrste autolognih venskih graftova. Upotrebljava se reversna tehnika, koja podrazumeva vadjenje vene iz lezista i postavljanje u obrnutom smeru, i in situ tehnika koja podrazumeva ostavljanje vene u svom lezistu sa naknadnim ekraziranjem postojecih valvula. Obe tehnike imaju svoje prednosti i mane tako da svaka od njih ima svoje indikaciono podrucje. Cilj rada je evaluacija vrednosti kao i procena prednosti svake od dve navedene tehnike. Na Klinici za vaskularnu i transplantacionu hirurgiju u Novom Sadu u periodu 1999-2003. godine operisano, 118 bolesnika sa infraingvinalnom distribucijom periferne arterijalne okluzivne bolesti kod kojih je uradjen 141 rekonstruktivni zahvat upotrebom stabla v. saphenae magnae. Podeljeni su u dve grupe. I grupu je cinilo 72 bolesnika kod kojih je uradjeno 86 in situ bypass procedura, a II grupu 46 bolesnika sa 55 reverznih venskih bypass-a. Postoperativno je funkcija proveravana dopler aparatom kao i merenjem porasta API indeksa u toku postoperativnog toka u odnosu na p