Feasibility and Outcomes of Femoral Vein Harvest for Dialysis Access and Arterial Reconstruction

J Surg Res. 2019 May:237:50-55. doi: 10.1016/j.jss.2018.11.036. Epub 2019 Jan 24.

Abstract

Background: We describe the feasibility and long-term outcomes of using femoral vein (FV) for arteriovenous fistula (AVF) and lower extremity bypass (LEB) creation.

Methods: All patients undergoing AVF or LEB using autogenous FV by a single surgeon (April 2006 to September 2013) were reviewed. Perioperative (30-d) complications and long-term outcomes are described.

Results: Forty-four patients underwent vascular reconstruction with FV (AVF = 27 and LEB = 17). Perioperative morbidity was 43.2%, including harvest site infection and or seroma in 15.9%. No patients suffered from compartment syndrome or venous thromboembolic event. At median follow-up of 50.0 mon, overall patency was 70.4% for AVF (primary = 37.0% and secondary = 70.3%) and 76.5% for LEB (primary = 70.6% and secondary = 76.5%). Long-term lower extremity swelling occurred in 18.2% of patients.

Conclusions: Perioperative morbidity following FV harvest is high, but long-term patency rates are excellent. FV harvest is feasible and should be considered as a valid conduit in patients without useable great saphenous vein or other more commonly used sources of autogenous vein.

Keywords: Arteriovenous fistula; Femoral vein; Lower extremity bypass.

MeSH terms

  • Aged
  • Arteries / surgery
  • Arteriovenous Shunt, Surgical / adverse effects
  • Arteriovenous Shunt, Surgical / methods*
  • Feasibility Studies
  • Female
  • Femoral Vein / transplantation*
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications / epidemiology
  • Intraoperative Complications / etiology
  • Lower Extremity / blood supply
  • Male
  • Middle Aged
  • Perioperative Period / statistics & numerical data
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Renal Dialysis / methods*
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Time Factors
  • Transplantation, Autologous / adverse effects
  • Transplantation, Autologous / methods
  • Treatment Outcome
  • Vascular Grafting / adverse effects
  • Vascular Grafting / methods*
  • Vascular Patency