Simultaneous ipsilateral infrainguinal angioplasty and bypass procedures
Mircea L Pavkov1, Patrick Lermusiaux, François Bleuet
1CHU Tours, Hôpital Trousseau, 37044 Chambray-Les-Tours, Tours, France.
Vascular
|March 27, 2007
Summary
This study shows that combining endovascular and open surgery for infrainguinal arterial reconstruction is effective. The combined approach achieved high limb salvage rates, offering good outcomes for patients with critical limb ischemia.
Area of Science:
- Vascular Surgery
- Endovascular Therapy
- Arterial Reconstruction
Background:
- Infrainguinal arterial disease poses significant challenges for limb salvage.
- Combined endovascular and open surgical techniques are increasingly explored for complex arterial reconstructions.
Purpose of the Study:
- To evaluate the efficacy of surgeon-performed combined ipsilateral endovascular and open arterial concomitant reconstruction at the infrainguinal level.
- To assess outcomes including technical success, limb salvage, and complication rates.
Main Methods:
- A retrospective analysis of 15 patients undergoing 15 combined infrainguinal procedures between 2000 and 2004.
- Patients were divided into two groups: inflow angioplasty (9 patients) and outflow angioplasty (6 patients).
- Indications included claudication, ischemic rest pain, and gangrene.
Main Results:
- Immediate technical success rate was 100%.
- Cumulative limb salvage at 42 months was 85%.
- Complications included graft occlusion, revision, myocardial infarction, stroke, and amputation in a minority of patients.
Conclusions:
- Simultaneous ipsilateral infrainguinal angioplasty and bypass procedures can be performed with favorable results.
- Inflow and outflow angioplasty facilitate shorter graft segments and improved bypass flow.
- Outflow angioplasty aids in healing ischemic lesions, and femoral inflow angioplasty shows a low restenosis rate.
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