This study clearly depicts that Critical limb ischemia requiring open revascularization in conduit-limited renal insufficiency patients offers unique management challenges. Challenges include life expectancy rates for these patients as well as arm vein harvest and future upper extremity dialysis access. The purpose of this study was to evaluate outcomes of splice vein bypasses in renal insufficiency patients in terms of future dialysis access needs and life expectancy. A retrospective review of a single group’s vascular registry was queried for patients undergoing splice vein bypasses with a diagnosis of renal insufficiency. Demographics, indications, surgical details, and outcomes were tabulated using standard statistical methods. Lower extremity bypasses were performed from January 2014 to June 2019. There were 222 patients who underwent a splice vein bypass during this time, of whom 40 had renal insufficiency described by the nephrologist as chronic kidney disease stage 4 or stage 5. Mean age was 70.9 years (55-91 years), and 29 patients were male (29/40 [72.5%]). Median follow-up was 18 months (range, 1-60 months). Two patients had arteriovenous grafts placed, of which neither patient’s arm vein was used for the bypass.


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