Durability of short bypasses to infragenicular arteries
| Autor: | R. Clement Darling, Devon E.M. Bock, Benjamin B. Chang, Robert P. Leather, Dhiraj M. Shah |
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| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Basilic Vein Limb salvage Greater saphenous vein Blood Pressure Radiography Interventional Veins Diabetes Complications Ischemia medicine.artery medicine Humans Knee Popliteal Artery Saphenous Vein Tibial artery Vein Vascular Patency Aged Aged 80 and over Medicine(all) Leg Intraoperative Care Foot business.industry Graft Survival Middle Aged Popliteal artery Surgery Tibial Arteries Posterior tibial artery medicine.anatomical_structure Popliteal to distal bypass Regional Blood Flow Anterior tibial artery Arm Disease Progression cardiovascular system Female Radiology Short bypasses Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. (4):440-444 |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/S1078-5884(05)80166-2 |
| Popis: | Objectives: The purpose was to test the durability of the use of the unobstructed popliteal or tibial arteries as alternative inflow sources. Materials: We examined 106 such bypasses performed during a 12 year period (1981–93). The indication for surgery was limb salvage in 99.1%. Seventy-five percent of the patients were male, 78% were diabetic and the average age was 59.6 years. The inflow source was the above-knee popliteal artery in 15 cases, the below-knee popliteal artery in 70 cases, the anterior tibial artery in 11 cases and the posterior tibial artery in 10 cases. Adequacy of inflow was determined by angiogram as well as intraoperative pressure measurement when indicated. Outflow was to a distal tibial or plantar arteries in 77.4% of the procedures. Forty-six bypasses were performed by an in situ technique.. Excised vein was used as conduit in 60 patients (56.6%); greater saphenous vein (38), lesser saphenous vein (10), cephalic/basilic vein (4), and spliced vein (8). Results: Operative mortality was 2.8%. Five year cumulative primary patency was 75.4% with a secondary patency of 82.6%. Five year cumulative limb salvage was 93.5%. Patency rate was not significantly different for various inflows or outflows. Only four of the 106 bypasses ultimately required a reconstruction from the femoral level for proximal progression of disease. Bypasses performed using an in situ technique showed a significantly better 5 year cumulative secondary patency rate (96.3%) than those done with excised vein (70.5%), p Conclusion: Results of this study indicate that use of the popliteal or tibial arteries as an inflow source in the absence of significant proximal disease carries acceptable results, especially when using the vein in situ . |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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