PREOPERATIVE SAPHENOUS VENOGRAPHY IN ARTERIAL RECONSTRUCTIVE SURGERY OF THE LOWER-EXTREMITY

Abstract

Preoperative spahenous venography was performed (100 extremities, 60 patients) to evaluate the saphenous vein for use as an arterial bypass graft. In 18 patients (30%) venography demonstrated vein abnormality, disease, or small size, the findings influenced the surgical and therapeutic treatment of the patient. Saphenous vein anatomy and diameter seen at surgery in 52 patients correlated with the venograms. The average diameter of the saphenous veins on preoperative venograms was 3.4 mm (range, 1.0-6.0 mm), the veins dilated to an average diameter 73 .+-. 5% greater than that seen venographically. The average diameter of harvested, dilated saphenous veins was 5.5 mm (range, 3.0-10.0 mm). Veins measuring 2.0 mm on the venograms dilated to 4.0 mm at operation and were suitable for femoropopliteal or small vessel bypass grafts; four 1.0 mm saphenous veins dilated to 3.0 mm and were suitable for small vessel bypasses. Preoperative saphenous venography can be used in lower extremity arterial reconstructions to detect anomalies and disease processes and identifies the venous segment that could be used preventing unnecessary incisions and minimizing operating time.