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Purpose: The purpose of this study was to evaluate the results of infrainguinal reconstructions with arm vein, lesser saphenous vein, and remnants of greater saphenous vein (ectopic vein grafts). Methods: The records of 222 patients who underwent 257 bypasses were retrospectively reviewed. Most of the grafts were placed for rest pain or tissue loss (88%) and were secondary reconstructions (70%) to the infrapopliteal level (90%). Single-length vein grafts were constructed in 66% of cases, whereas 34% were composite vein grafts. Results: Secondary graft patency was 70%, 52%, and 43% at 1, 3, and 5 years. Single-length grafts had significantly better patency rates at all intervals: 78% versus 56% at 1 year ( p = 0.001), 60% versus 39% at 3 years ( p = 0.004), and 52% versus 29% at 5 years ( p = 0.002). The limb salvage rate was 69% at 5 years. Conclusions: Ectopic vein grafts with primarily arm vein are an acceptable alternative for infrainguinal reconstruction in the absence of suitable ipsilateral greater saphenous vein. (J VASC SURG 1994;20:451-7.)

BACKGROUND The objective of the current metaanalysis was to evaluate the expression patterns of matrix metalloproteinases (MMPs) in patients with head and neck squamous cell carcinoma (HNSCC), to evaluate reported series, and to determine whether there is an expressed value to quantitate the risk of metastasis. METHODS A review of the published literature was conducted according to defined selection criteria. Fixed and random effects models were applied for estimation of the summarized odds ratio and 95% confidence intervals, including a test for homogeneity of the odds ratios of the studies. Finally, forest plots were created to allow for visual comparison of the results and an estimation of heterogeneity. RESULTS The heterogeneity of data collection and statistical methods did not allow final judgments on the significance of immunohistochemical MMP expression analysis in patients with HNSCC or the impact of MMPs in predicting metastatic behavior. Fourteen studies with 710 patients for 5 different MMPs (MMP-1, MMP-2, MMP-3, MMP-9, and MMP-14) were included in the current metaanalysis. The results indicated that MMP-2, MMP-3, MMP-14 possibly played a role in the metastatic behavior of HNSCC tumors. CONCLUSIONS The authors recommended the standardization of staining procedures and evaluation protocols as a necessary step to allow for valid comparisons of the multitude of results published by different study groups. Cancer 2005. © 2005 American Cancer Society.