• Reinforced long saphenous vein bypass graft for infrainguinal reconstruction procedures: case series and literature review.

      Hynes, Niamh; Mahendran, Bhasakarapandian; Tawfik, Sherif; Sultan, Sherif; Department of Vascular & Endovascular Surgery, Galway, Clinic, Doughiska, Co. Galway, Ireland. (Vascular, 2006-03)
      Poor rehabilitation rates and the high-cost of managing postamputation patients justify an aggressive revascularization policy in critical lower limb ischemia. Endovascular therapy is our first choice for limb salvage in these patients. However there are patients for whom endovascular therapy is not feasible. When bypass is necessary, autologous vein is a superior conduit to synthetic material. However, varicosities usually contraindicate autologous vein bypass because of the risk of aneurysm formation, rupture and increased intimal hyperplasia compared with nonvaricose venous grafts. We report the use of varicosed long saphenous vein (LSV) with external Dacron support in infrainguinal bypass procedures for limb salvage, where endovascular therapy was not feasible. The external Dacron tube was not brought close to the distal anastomotic area itself. With a mean follow-up of 18 months, duplex ultrasonography and computed tomography angiography showed no evidence of stenosis of the reinforced vein segments or aneurysmal degeneration of the residual vein. External reinforcement with Dacron prosthesis allows the use of autogenous greater saphenous veins with varicose dilatation without compromising graft patency and limb salvage.
    • Variations in the usage and composition of a radial cocktail during radial access coronary angiography procedures.

      Pate, G; Broderick, B; The Galway Clinic, Doughiska, Galway. gordon.pate@galwayclinic.com (2011-10)
      A survey was conducted of medication administered during radial artery cannulation for coronary angiography in 2009 in Ireland; responses were obtained for 15 of 20 centres, in 5 of which no radial access procedures were undertaken. All 10 (100%) centres which provided data used heparin and one or more anti-spasmodics; verapamil in 9 (90%), nitrate in 1 (10%), both in 2 (20%). There were significant variations in the doses used. Further work needs to be done to determine the optimum cocktail to prevent radial artery injury following coronary angiography.