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Sukovatykh BS, Belikov LN, Rodionov AO, Sukovatykh MB, Grigorian AY. [Effectiveness of biological prosthesis for femoro-femoral bypass in high risk patients]. Khirurgiia (Mosk) 2018:86-90. [PMID: 29798997 DOI: 10.17116/hirurgia2018586-90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To compare synthetic and biological prostheses for femoral bypass surgery. MATERIAL AND METHODS There were 40 patients with critical ischemia of lower extremities due to atherosclerotic lesion of aorto-iliac segment and severe comorbidities. They were divided into 2 groups by 20 patients. C-shaped femoro-femoral bypass with synthetic polytetrafluoroethylene and lavsan prostheses was performed in the first group and S-shaped bypass procedure with biological prosthesis from the internal thoracic arteries of the bull - in the second group. RESULTS Biological prosthesis is associated with reduced early postoperative morbidity by 10%, late graft thrombosis incidence by 20% and increased physical and psychological health by 7.1%. CONCLUSION S-shaped femoro-femoral bypass with a biological prosthesis from the internal thoracic arteries of the bull is pathogenetically substantiated and effective.
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Affiliation(s)
- B S Sukovatykh
- Chair of General Surgery, Kursk State Medical University of Healthcare Ministry of the Russian Federation, Kursk, Russia
| | - L N Belikov
- Chair of General Surgery, Kursk State Medical University of Healthcare Ministry of the Russian Federation, Kursk, Russia
| | - A O Rodionov
- Chair of General Surgery, Kursk State Medical University of Healthcare Ministry of the Russian Federation, Kursk, Russia
| | - M B Sukovatykh
- Chair of General Surgery, Kursk State Medical University of Healthcare Ministry of the Russian Federation, Kursk, Russia
| | - A Yu Grigorian
- Chair of General Surgery, Kursk State Medical University of Healthcare Ministry of the Russian Federation, Kursk, Russia
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Venous Conduits Have Superior Patency Compared with Prosthetic Grafts for Femorofemoral Bypass. Ann Vasc Surg 2018; 52:126-137. [PMID: 29783030 DOI: 10.1016/j.avsg.2018.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 03/08/2018] [Accepted: 03/19/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The objective of the study was to compare the outcomes of externally supported polytetrafluoroethylene (PTFE) grafts and femoral vein as conduits for femorofemoral crossover grafts. METHODS This is a retrospective review of consecutive femorofemoral crossover grafts at our institution between January 2005 and March 2016. Patient demographics, indications, complication rates, patency rates, and survival rates were compared between femorofemoral grafts created with either PTFE or femoral vein conduits, autogenous or cryopreserved. RESULTS One hundred nineteen femorofemoral crossover bypasses (89 PTFE, 30 vein [18 autogenous and 12 cryopreserved femoral veins]) were performed. Most patients underwent isolated femorofemoral bypass alone (76% isolated femorofemoral bypass versus 24% axillobifemoral bypass). A greater proportion of patients who received vein grafts were female (PTFE 37% vs. vein 60%, P = 0.028) and had prior bypasses (PTFE 33% vs. vein 73%, P < 0.001). PTFE bypasses were performed primarily for chronic limb ischemia (61.8%), while most venous bypasses were for infections (80%, P < 0.001). Femoral vein conduits were used in cases of infected aortic or extra-anatomical grafts (N = 20) or groin infection (N = 5). The 30-day complication rate was 38.7% and was not different between groups (36% for PTFE, 44.4% for autologous vein grafts and 50% for cryovein, P = 0.33) with wound complications being most frequent (18% PTFE, 27.8% autologous vein, 16.7% cryovein, P = 0.25). Patients receiving vein grafts were more likely to receive blood transfusion (34.8% PTFE vs. 70% vein, P = 0.001). Overall, median follow-up was 9.8 months (range 0-107). Primary patency rates at 1, 2, and 3 years were 83.7 %, 73.7% and 69.8%, respectively, for PTFE bypasses, and 100% for all time points for venous grafts, respectively (log rank, P = 0.03). Primary-assisted and secondary patency rates were not significantly different between the 2 groups (log rank, P = 0.16). Survival rates at 1, 2, and 3 years were 82%, 76.4% and 69.7%, respectively, for patients with PTFE grafts versus 76.7%, 73.3%, and 55%, respectively, for patients with vein grafts, respectively (log rank, P = 0.17). CONCLUSIONS While the indications for procedure differed in this series, femoral veins in femorofemoral bypasses have overall superior primary patency and similar complication rates compared with PTFE grafts. Based on this series, femoral vein, either autologous or cryopreserved, appears to be a suitable conduit for femorofemoral bypasses, and in some cases, it may be the preferred conduit.
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Park KM, Park YJ, Kim YW, Hyun D, Park KB, Do YS, Kim DI. Long Term Outcomes of Femorofemoral Crossover Bypass Grafts. Vasc Specialist Int 2017; 33:55-58. [PMID: 28690996 PMCID: PMC5493187 DOI: 10.5758/vsi.2017.33.2.55] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/05/2017] [Accepted: 04/03/2017] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Femorofemoral crossover bypass (FCB) is a good procedure for patients with unilateral iliac artery disease. There are many articles about the results of FCB, but most of them were limited to 5 years follow-up. The purpose of our study was to analysis the results of FCB with a 10-year follow-up period. MATERIALS AND METHODS Between January 1995 and December 2010, 133 patients were operated in Samsung Medical Center (median follow-up: 58.8 months). We retrospectively analysed patient characteristics, the preoperative treatment, the operative procedure, and material used. RESULTS The indications for FCB were claudication in 110 and critical limb ischemia in 23 patients. Three patients were died due to myocardiac infarction, intracranial hemorrhage, and acute respiratory failure within 30 days after surgery. The one-year primary and secondary patency rates were 89% and 97%, the 5-year primary and secondary patency rates were 70% and 85%, and the 10-year primary and secondary patency rates were 31% and 67%. The 5-year and 10-year limb salvage rates were 97% and 95%, respectively. CONCLUSION Our long term analysis suggests that FCB might be a valuable alternative treatment modality in patients with unilateral iliac artery disease.
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Affiliation(s)
| | - Yang-Jin Park
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Wook Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dongho Hyun
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Bo Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Soo Do
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Ik Kim
- Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Obinwa O, Canning C, O'Donohoe M. Bilateral prevascular herniae - A rare complication of aorto-uniiliac endovascular abdominal aortic aneurysm repair and femoro-femoral bypass. Int J Surg Case Rep 2015; 11:5-7. [PMID: 25890122 PMCID: PMC4446676 DOI: 10.1016/j.ijscr.2015.03.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/30/2015] [Accepted: 03/31/2015] [Indexed: 12/02/2022] Open
Abstract
A case of a 78-year-old female with bilateral prevascular groin herniae following an emergency aorto-uniiliac EVAR and femoro-femoral bypass for a ruptured abdominal aortic aneurysm is presented. Primary repair of the herniae was achieved using a preperitoneal approach. The case emphasises a safe approach for dealing with this rare complication.
A case of a 78-year-old female with bilateral groin prevascular herniae following an emergency aorto-uniiliac EVAR and femoro-femoral bypass for a ruptured abdominal aortic aneurysm is presented. Primary repair of the herniae was achieved using a preperitoneal approach. The case emphasises a safe approach to dealing with this rare complication.
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Affiliation(s)
- Obinna Obinwa
- Department of Vascular Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
| | - Caitriona Canning
- Department of Vascular Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
| | - Martin O'Donohoe
- Department of Vascular Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
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Nakae R, Matsuzaki S, Egawa-Takata T, Mimura K, Kanagawa T, Kimura T. Pregnancy management for a patient with graft occlusion after right iliac artery bypass surgery. J Obstet Gynaecol Res 2014; 41:979-84. [PMID: 25511914 DOI: 10.1111/jog.12636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
Abstract
We describe an extremely rare case of a pregnant woman who had a successful delivery despite developing bypass graft occlusion after right external iliac bypass surgery. External and common iliac artery bypass surgery is often performed when arteriosclerosis obliterans or thromboangiitis obliterans result in iliac artery occlusion or when revascularization is required because of iliac artery injury. Because arteriosclerosis obliterans and thromboangiitis obliterans rarely develop in young women or girls, most physicians have little experience with graft occlusion after iliac artery bypass surgery. Here we describe and discuss the published work pertaining to this extremely rare case.
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Affiliation(s)
- Ruriko Nakae
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shinya Matsuzaki
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomomi Egawa-Takata
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuya Mimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takeshi Kanagawa
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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Ma T, Ma J. Femorofemoral Bypass to the Deep Femoral Artery for Limb Salvage after Prior Failed Percutaneous Endovascular Intervention. Ann Vasc Surg 2014; 28:1463-8. [DOI: 10.1016/j.avsg.2014.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/28/2014] [Accepted: 02/08/2014] [Indexed: 10/25/2022]
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Kim YS, Yun WS, Park K. Long-term outcome of crossover femoro-femoro-popliteal bypass using side-to-side anastomosis in ilio-femoral occlusive disease. Ann Surg Treat Res 2014; 86:91-4. [PMID: 24761414 PMCID: PMC3994596 DOI: 10.4174/astr.2014.86.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 10/13/2013] [Accepted: 10/24/2013] [Indexed: 11/30/2022] Open
Abstract
Purpose During crossover femoro-femoro-popliteal sequential bypass (CFFPB) surgery in ilio-femoral occlusive disease, proximal anastomosis of the femoro-popliteal bypass is usually performed distal to the distal anastomosis of the crossover femoro-femoral bypass. If not, it is done with a piggyback configuration. Another method is a side-to-side anastomosis. Its benefit is that this is the only anastomosis made. And it is less bulky compared with the piggyback configuration. This study was aimed to investigate the long-term outcome of CFFPB using side-to-side anastomosis. Methods From Sep 2006 to Aug 2012, 21 patients who underwent CFFPB using side-to-side anastomosis were enrolled. Externally supported polytetrafluoroethylene graft was used as a conduit in all patients. Patient demographic data and procedure details were investigated. Primary graft patency was calculated using the Kaplan-Meier method. Results The mean age of patients was 79 years (range, 62-81 years) and males were 17 (81%). Fifteen patients (71%) had critical limb ischemia. Inflow arteries comprised of 16 common femoral artery (CFA), 4 superficial femoral artery (SFA), and 1 deep femoral artery (DFA). Side-to-side anastomosis was performed on the CFA in 11, SFA in 2, and DFA in 8 patients. During the mean follow-up period of 21 months (1-60 months), 8 patients died. The 1-, 3-, and 5-year primary patency rates were 76%, 63%, and 63%. Conclusion Long-term patency of CFFPB using side-to-side anastomosis was acceptable. It can be one of the treatment options for patients with ilio-femoral occlusive disease.
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Affiliation(s)
- Yoon-Sub Kim
- Division of Vascular/Endovascular Surgery, Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Woo-Sung Yun
- Division of Vascular/Endovascular Surgery, Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Kihyuk Park
- Division of Vascular/Endovascular Surgery, Department of Surgery, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea
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Dosluoglu HH. Commentary: Endovascular Therapy Should Be the First Line of Treatment in Patients With Severe (TASC II C or D) Aortoiliac Occlusive Disease. J Endovasc Ther 2013; 20:74-9. [DOI: 10.1583/12-4014c.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bonardelli S, Nodari F, De Lucia M, Cervi E, Giulini SM. Crossover ilio-iliac bypass and removal of femoro-femoral graft as first treatment for the infection of crossover bypass in aorto-uni-iliac endovascular aneurysm repair. Vascular 2012; 20:306-10. [PMID: 23019606 DOI: 10.1258/vasc.2011.tn0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The crossover femoro-femoral bypass, classically used for the treatment of unilateral iliac arterial obstruction, has recently become an integral part of aorto-uni-iliac endovascular aneurysm repair. We therefore, reconsider the therapeutic problems related to thrombosis and in particular to infection of the femoro-femoral prosthesis, when many attempts have been made to preserve the bypass and treat the infection. Showing a case treated and well eight months later, we put forward the old technique of crossover ilio-iliac bypass, followed by the removal of the infected femoro-femoral graft. In our opinion, this technique circumvents the need for autologous tissue and allows for the use of prosthetics in a new, sterile, uncontaminated field. As this approach for these cases has so far not been reported in the literature, further cases and long-term follow-up are needed.
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Simms J, El-Sakka K, Valenti D, Tyrrell M, Schulte KM. Small bowel obstruction due to herniation into an extra-anatomical arterial bypass tunnel: a first case report. Ann R Coll Surg Engl 2010; 92:W20-2. [PMID: 20353629 DOI: 10.1308/147870810x476728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION We highlight the importance of considering rarer causes of small bowel obstruction in patients presenting after extra-anatomical arterial bypass. CASE PRESENTATION Our patient underwent a left common iliac-to-bifemoral bypass extra-anatomical graft for critical limb ischaemia. The patient developed mechanical small bowel obstruction on the 20th postoperative day. Emergency laparotomy revealed incarcerated, obstructed small bowel trapped in the graft tunnel. Recovery was satisfactory following small bowel resection. CONCLUSIONS To the best of our knowledge, small bowel herniation into an arterial bypass graft tunnel, with successful treatment outcome, has not been reported to date.
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Affiliation(s)
- Jacqueline Simms
- Department of Vascular Surgery, King's College Hospital, London, UK
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Beard JD. Which is the best revascularization for critical limb ischemia: Endovascular or open surgery? J Vasc Surg 2008; 48:11S-16S. [DOI: 10.1016/j.jvs.2008.08.036] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Revised: 08/06/2008] [Accepted: 08/12/2008] [Indexed: 11/25/2022]
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Thuijls G, van Laake L, Lemson M, Kitslaar P. Usefulness and Applicability of Femorofemoral Crossover Bypass Grafting. Ann Vasc Surg 2008; 22:663-7. [DOI: 10.1016/j.avsg.2008.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Revised: 02/25/2008] [Accepted: 04/28/2008] [Indexed: 11/26/2022]
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Ricco JB, Probst H. Long-term results of a multicenter randomized study on direct versus crossover bypass for unilateral iliac artery occlusive disease. J Vasc Surg 2008; 47:45-53; discussion 53-4. [PMID: 17997269 DOI: 10.1016/j.jvs.2007.08.050] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Revised: 08/21/2007] [Accepted: 08/21/2007] [Indexed: 10/22/2022]
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Exton RJ, Galland RB. Major Groin Complications Following the Use of Synthetic Grafts. Eur J Vasc Endovasc Surg 2007; 34:188-90. [PMID: 17512763 DOI: 10.1016/j.ejvs.2007.03.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Accepted: 03/18/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND The ideal results of vascular reconstructive surgery include an uncomplicated operation, symptomatic relief, prompt wound healing, rapid return to pre-operative functional status without long term functional consequences. Long term complications are often not emphasized. This study describes false femoral aneurysms (FFA) and infection following use of synthetic graft in the groin. METHODS All patients under the care of one surgeon, undergoing synthetic graft insertion involving the groin between January 1988 and December 2005 were included. RESULTS Some 489 patients were included (745 at risk groins). A total of 34 patients developed either FFA or infection, involving 39 groins (5.2%). There were 18 FFA, presenting a median of four years after the original operation. FFA was more common following aortofemoral bypass grafts than femorofemoral or femorodistal bypasses (P=0.0084). Repair with interposition grafting was carried out in 17 cases. There was one death postoperatively. The remainder remained satisfactory at a median follow up of 60 months. Median time from original operation to 21 groin infections presenting was 12 months. Infection was commonest after femorofemoral cross over grafts P=0.023. Four major amputations were carried out. Debridement and sartorius transposition was useful in about half of the cases treated. CONCLUSION Serious groin complications occur in about 5% of cases following use of a synthetic graft. This can result in significant morbidity long after the original operation has been carried out. Patients need to be made aware of this when obtaining informed consent.
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Affiliation(s)
- R J Exton
- Department of Surgery, Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK
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Eiberg JP, Røder O, Stahl-Madsen M, Eldrup N, Qvarfordt P, Laursen A, Greve M, Flörenes T, Nielsen OM, Seidelin C, Vestergaard-Andersen T, Schroeder TV. Fluoropolymer-coated Dacron Versus PTFE Grafts for Femorofemoral Crossover Bypass: Randomised Trial. Eur J Vasc Endovasc Surg 2006; 32:431-8. [PMID: 16807001 DOI: 10.1016/j.ejvs.2006.04.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Accepted: 04/06/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery. DESIGN A randomised multicentre clinical trial comparing two vascular grafts with participation of 10 departments of vascular surgery in Denmark, Sweden and Norway. PATIENTS AND METHODS 198 patients were randomised to PTFE (n=107) or fluoropolymer-coated Dacron grafts (n=91), 63% underwent surgery for claudication, 27% for ischaemic rest pain and 10% for tissue loss. The median follow-up time was 24 months (IQR 19-26 months). RESULTS The primary patency rate of the two grafts was similar (log rank test: p=0.35). The primary patency rates (95% CI) for coated Dacron and PTFE grafts were 92% (86-98) and 94% (89-99) at 12 months and 87% (74-95) and 93% (87-99) at 24 months, respectively. CONCLUSION In patients with unilateral iliac artery disease not amenable to angioplasty, the femoral-femoral bypass is durable and effective. No difference in patency was found between the two graft materials (fluoropolymer coated Dacron and PTFE).
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Affiliation(s)
- J P Eiberg
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
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