Autogenous Saphenous Vein Aortorenal Grafts

Abstract

Sixty-six patients underwent renal revascularization with 75 autogenous saphenous vein grafts. Ninety-four percent were cured or improved of their hypertension. No operative deaths occurred. One-hundred thirty postoperative arteriograms, obtained an average of 36 months following revascularization, were scrutinized for vein graft abnormalities. Two graft categories were identified: satisfactory and unsatisfactory. Uniform expansion of satisfactory grafts was common. Unsatisfactory grafts included six thromboses, five stenoses, and five aneurysmal dilatations. Thromboses occurred within two weeks of operation. Presuming thromboses to be technical failures, then 14% of grafts at risk developed abnormalities. No late occlusions occurred. Autogenous veins are well suited for precise anastomoses, extending the ability to revascularize ischemic kidneys that, on occasion, have been needlessly sacrificed in the past. Repeated postoperative arteriograms are mandatory to assure optimal function and integrity of aortorenal vein grafts.