The basilic vein: an alternative conduit for complex iliofemoral reconstruction.

Abstract

To evaluate the basilic vein as an alternative conduit in iliofemoral arterial reconstructions. Retrospective cohort study. We reviewed records of all patients undergoing iliofemoral arterial reconstruction with basilic vein between January 2006 and November 2011. Patients were identified via a prospective database, which also provided data on patients' comorbidity, indications for surgery and perioperative outcome. Long term outcome was confirmed by reviewing hospital records; graft patency was confirmed by clinical examination and imaging by ultrasound or CT angiography. We identified 15 patients undergoing 17 procedures (two patients underwent staged bilateral iliofemoral bypasses). Indications for vein (instead of prosthetic) graft use included prosthetic infection (4), suspected infection (2), proven hypercoagulable state (3), young age (3) and multiple graft occlusions (5). Preoperative mapping confirmed vein suitability in all cases, and all conduits were harvested from the upper limb. There were no major perioperative complications. After a median (range) follow up of 21.5 (1-42) months, all grafts were patent; one patient required secondary intervention on the graft. Iliofemoral arterial reconstruction with autologous basilic vein is feasible and may be a valid alternative when the use of prosthetic material is contraindicated.