Related Experiment Videos
Long term follow-up of descending thoracic aorto-iliac/femoral bypass
D E Bowes1, J R Youkey, W P Pharr
1Geisinger Medical Center, Danville, PA.
Insights
Descending thoracic aorto-iliac/femoral (DTAI/F) bypass offers an 86% primary patency rate in selected high-risk patients. This procedure is a viable alternative when conventional aortic surgery is too hazardous.
Area of Science:
- Vascular Surgery
- Cardiovascular Surgery
- Surgical Outcomes
Background:
- Conventional surgical approaches to the aorta can be associated with significant risks.
- Complex aortic pathologies necessitate alternative treatment strategies.
- Descending thoracic aorto-iliac/femoral (DTAI/F) bypass presents a potential solution for challenging cases.
Purpose of the Study:
- To evaluate the outcomes of descending thoracic aorto-iliac/femoral (DTAI/F) bypass in a cohort of patients.
- To assess the efficacy and safety of DTAI/F bypass for complex aortic conditions.
Main Methods:
- A prospective study involving 26 patients undergoing DTAI/F bypass over 13 years.
- Average follow-up of 53 months.
- Analysis of indications, operative mortality, late mortality, and graft patency.
Main Results:
- Operative mortality was 3.8%.
- Late mortality was 36%, with various causes including renal failure and carcinoma.
- Primary cumulative patency was 86% at 42 months, with 4 instances of graft failure at different time points.
Conclusions:
- DTAI/F bypass is a recommended procedure for carefully selected patients.
- It serves as a valuable alternative when conventional aortic interventions are deemed excessively hazardous.
- The study highlights the long-term patency and risks associated with this surgical approach.
Abstract:
A prospective study of 26 patients undergoing descending thoracic aorto-iliac/femoral (DTAI/F) bypass was conducted over a 13-year period with an average follow up of 53 months. Reasons for selecting the procedure were occluded aortic bifurcation grafts (9 patients), hostile abdomen (6), infected aortic graft (1), microaorta (10, and surgeons preference in 8 patients who had juxtarenal aortic occlusion. The operative mortality was 3.8% (1 patient). A late mortality of 36% was due to myocardial infarction (1), lung carcinoma (2), renal failure (4), stroke (1) and pulmonary insufficiency (1). Graft failure occurred in 4 patients at 23, 26, 54 and 109 months respectively. Primary cumulative patency was 86% statistically valid at 42 months. DTAI/F bypass is recommended in selected patients when conventional approaches to the aorta are considered unduly hazardous.