PMID- 36633545
OWN - NLM
STAT- MEDLINE
DCOM- 20230313
LR  - 20230313
IS  - 1827-1839 (Electronic)
IS  - 0392-9590 (Linking)
VI  - 42
IP  - 1
DP  - 2023 Feb
TI  - Mills valvulotome reduces distal vein injuries and improves follow-up freedom 
      from restenosis in patients undergoing infrainguinal in-situ saphenous vein 
      bypass.
PG  - 19-25
LID - 10.23736/S0392-9590.22.04982-3 [doi]
AB  - BACKGROUND: In this study, the early and mid-term outcomes of the use of the 
      Mills valvulotome in patients with chronic limb-threatening ischemia (CLTI) 
      undergoing infrainguinal in-situ saphenous vein bypass were investigated. 
      METHODS: From January 2018 until December 2019, 153 consecutive CLTI patients 
      from 7 centers have been treated with infrainguinal in-situ saphenous vein 
      bypass. In all patients the devalvulation of the great saphenous vein (GSV) was 
      obtained with the use of the HYDRO LeMaitre((R)) valvulotome (LeMaitre Vascular, 
      Burlington, MA, USA). Eighty-six patients (56.2%) received the additional 
      treatment of the LeMills valvulotome (LeMaitre Vascular) to disrupt the distal 
      valves of the GSV (Group MV), whilst in the remaining 67 patients (43.8%) this 
      adjunctive device was not used (Group no-MV). Initial outcome measures including 
      intraoperative vein injuries were assessed and compared. At 2-year follow-up, 
      estimated outcomes of primary patency, primary assisted patency, secondary 
      patency, freedom from distal vein restenosis, and limb salvage were analyzed 
      using Kaplan-Meier curves and compared between groups using the log-rank test. 
      RESULTS: Intraoperatively, the overall rate of vein injuries related to the 
      devalvulation was 5.2% (8 cases) with four cases in both groups (4/86, 4.6%, 
      Group MV vs. 4/67, 6%, Group no-MV; P=0.49). Overall, 4 lesions occurred in the 
      distal portion of the GSV and were all reported in Group no-MV (0/86, 0%, Group 
      MV vs. 4/67, 6%, Group no-MV; P=0.03). Median duration of follow-up was 12 months 
      (IQR: 6-24). At 2-year follow-up there were no differences between the two groups 
      in terms of primary patency (69.9% Group MV vs. 79.8% Group no-MV, P=0.08), 
      primary assisted patency (85.4% Group MV vs. 90.5% Group no-MV, P=0.37), 
      secondary patency (94.2% Group MV vs. 92.1% Group no-MV, P=0.61), and limb 
      salvage (97.4% Group MV vs. 98.2% Group no-MV, P=0.74). Patients in Group MV had 
      a higher rate of freedom from distal vein restenosis (92.2% Group MV vs. 76% 
      Group no-MV, P=0.03). CONCLUSIONS: Adjunctive use of the Mills valvulotome 
      (LeMaitre Vascular) reduces intraoperative distal vein injuries and improves the 
      2-year freedom from distal vein restenosis in patients undergoing infrainguinal 
      in-situ saphenous vein bypass.
FAU - Troisi, Nicola
AU  - Troisi N
AD  - Unit of Vascular Surgery, Department of Translational Research and New 
      Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy - 
      nicola.troisi@unipi.it.
FAU - Michelagnoli, Stefano
AU  - Michelagnoli S
AD  - Unit of Vascular and Endovascular Surgery, San Giovanni di Dio Hospital, 
      Florence, Italy.
FAU - Salvini, Mauro
AU  - Salvini M
AD  - Unit of Vascular Surgery, Ospedale Civile Santi Antonio e Biagio e Cesare Arrigo, 
      Alessandria, Italy.
FAU - DE Blasis, Giovanni
AU  - DE Blasis G
AD  - Unit of Vascular Surgery, Ospedale Santi Filippo e Nicola, Avezzano, L'Aquila, 
      Italy.
FAU - Ercolini, Leonardo
AU  - Ercolini L
AD  - Unit of Vascular Surgery, San Donato Hospital, Arezzo, Italy.
FAU - Pratesi, Carlo
AU  - Pratesi C
AD  - Department of Vascular Surgery, University of Florence, Florence, Italy.
FAU - Frosini, Pierfrancesco
AU  - Frosini P
AD  - Unit of Vascular Surgery, San Jacopo Hospital, Pistoia, Italy.
FAU - Berchiolli, Raffaella
AU  - Berchiolli R
AD  - Unit of Vascular Surgery, Department of Translational Research and New 
      Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
LA  - eng
PT  - Journal Article
DEP - 20230112
PL  - Italy
TA  - Int Angiol
JT  - International angiology : a journal of the International Union of Angiology
JID - 8402693
SB  - IM
MH  - Humans
MH  - *Saphenous Vein/surgery
MH  - Vascular Patency
MH  - *Vascular Surgical Procedures
MH  - Femoral Vein
MH  - Limb Salvage
MH  - Treatment Outcome
MH  - Retrospective Studies
MH  - Ischemia/surgery
MH  - Risk Factors
EDAT- 2023/01/13 06:00
MHDA- 2023/03/14 06:00
CRDT- 2023/01/12 10:16
PHST- 2023/01/13 06:00 [pubmed]
PHST- 2023/03/14 06:00 [medline]
PHST- 2023/01/12 10:16 [entrez]
AID - S0392-9590.22.04982-3 [pii]
AID - 10.23736/S0392-9590.22.04982-3 [doi]
PST - ppublish
SO  - Int Angiol. 2023 Feb;42(1):19-25. doi: 10.23736/S0392-9590.22.04982-3. Epub 2023 
      Jan 12.