ArticleVascular specialist international2026
Great Saphenous Vein Availability in Lower‑Extremity Arterial Disease: Analysis of a Prospectively Mapped Nonselective Cohort.
Article in Vascular specialist international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: This study aimed to quantify the real-world availability of a single-segment great saphenous vein (GSV) in a nonselective Korean cohort with peripheral arterial disease and to identify patient-level predictors that may limit the adoption of a vein-first strategy. Materials and Methods: This retrospective analysis of prospectively collected data included 115 consecutive patients admitted for evaluation and planning of lower-extremity revascularization (53 with claudication and 62 with chronic limb-threatening ischemia [CLTI]) from 2023 to 2024. All patients underwent mandatory bilateral duplex mapping before treatment by registered vascular technologists under a standardized protocol (reverse Trendelenburg position, temperature 25°C-26°C, inner-to-inner measurements). A suitable single-segment conduit was defined as a continuous, thrombus-free GSV from the saphenofemoral junction to the proximal calf without duplex-detected reflux and was categorized by minimum diameter as ideal (≥3.0 mm), acceptable (≥2.5 mm), or borderline (≥2.0 mm). Results: In the ipsilateral limb, the GSV met the ideal, acceptable, and borderline thresholds in 23/115 (20.0%), 39/115 (33.9%), and 57/115 (49.6%) patients, respectively. When the contralateral limb was included, overall availability (either limb) increased to 28/115 (24.3%), 58/115 (50.4%), and 75/115 (65.2%), corresponding to absolute gains of 4.3, 16.5, and 15.6 percentage points, respectively. Ipsilateral and overall ideal availability tended to be lower in CLTI than in claudication (14.5% vs. 26.4%, P=0.112 for ipsilateral; 17.7% vs. 32.1%, P=0.074 for overall). On multivariable analysis, older age and female sex were independently associated with reduced overall ideal availability (adjusted odds ratio [aOR] per year, 0.932; 95% confidence interval [CI], 0.887-0.979; female sex: aOR, 0.201; 95% CI, 0.046-0.869). Conclusion: In this consecutive real-world cohort, ideal single-segment GSV availability (≥3.0 mm) was low and was further limited by older age and female sex. These findings highlight an important limitation of a vein-first strategy in routine practice and support standardized bilateral mapping to clarify conduit availability and guide individualized revascularization planning.
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