AboutLauri Ordway Expertise I can answer your questions related to peripheral vacular disorders. This includes all arteries and veins except those inside the head and inside the heart. IE: neck (carotid), arms (carotid subclavian bypases to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wound treatments. Also, Raynauds, Buerger`s disease, Thoracic Outlet and other miscellaneous vascular disorders.
I CANNOT answer questions about your heart disease, blood pressure, brain aneurysm, although I can help with questions about the arteries that go to and from those organs.
Experience I am a nurse, I have worked for 14 years with two terrific peripheral vascular surgeons, one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage our clinic website and field questions from patients all over the world.
Expert: Lauri Ordway Date: 5/26/2005 Subject: synthetic veins
Question -------------------------
Followup To
Question -
age 67, weight 160, non-smoker, have had quintriple bypass with vein used from right leg.
Angiogram shows both legs have blockages between the groin and the knee, blood flow is good from knee down.
As the vein from my right leg has already been used for heart bypass, the only alternative is synthetic veins. I know the maximum time they seem to last is 5 years. Can they be replaced after that?
Thanks in advance.
Answer -
Jack, the synthetic veins do much better above than below the knee, so you've got that going for you, why wouldn't he use the vein in your arm? we have done that with success. Lauri
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Lauri, thanks for your prompt response!
I saw one mention of using the veins from the arm on the net today, nothing going into it in any detail. Can you refer me to a site so that I can research it before I see my vascular surgeon for follow up after yesterdays angio? Or maybe you can give me further information?
Also, if I am stuck with synthetic veins, what happens after they quit working, amputation?
I like to know all my options before my doctor tries to tell me why things can't be done. :-)
Thanks again.
Jack
Answer Jack, I just did a google search with
'femoral popliteal bypass with brachial vein'
and got a good number of hits, take a look at them and see what you think. also, cadaver veins are an option in some cases, but always always always the best bet is your own vein.If you are stuck with synthetic veins they should still be monitored by ultrasound on a routine, regular basis. Our routine is ultrasound for graft patency and flow velcoity at 1, 3, 6, 12, 18 months and then everty 6 months forever. Sometimes, after 10 plus years we have let folks go to annual ultrasound scan if it is an issue of some sort for the patient, but we prefer to see that scan twice a year. If you keep an eye on it like that, you are way more likely to be able to intervene in a less dramatic way, like interventional radiology instead of surgery. For example, they may be able to just use an IV drip into the bypass with a clot buster drug instead of having to re-bypass. If you wait for symptoms to prompt an ulstrasound exam, the odds go way up that the repair will have to be surgical. We have excellent clinical data that the simple little ultrasound scan done routinely, can save many legs from further bypass or amputation.
You should not have to have amputation just because a synthetic veins fails, you can be bypassed as long as the anatomy is such thatbypass remains possible.
One thing is with the Gortex vein the chances you will need to be on blood-thinners long term.
Also, if you feel that answers you get in the reading of your angio, remember, you can get a second opinion anytime. Expecially in this day and age, you caould even email the angio films to someone just for that 2nd or 3rd opinion before you decide how to proceed. By the way, where, geographically, are you?
Best of luck! Lauri
