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End-to-side aortoprosthetic anastomoses: long-term computed tomography assessment
1Service de Chirurgie Cardio-Vasculaire, Hôpital Cardiologique, Lille, France.
Annals of Vascular Surgery
|November 1, 1990
Summary
End-to-side aortobifemoral bypass grafts show significant dilation and complications like false aneurysms and thrombosis years after surgery. These findings question the long-term safety of this surgical technique for aortofemoral bypass.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Aortobifemoral bypass grafts are crucial for treating aortoiliac occlusive disease.
- Long-term complications of end-to-side anastomoses in these grafts require further investigation.
Purpose of the Study:
- To evaluate the long-term structural integrity and complications of end-to-side aortobifemoral bypass grafts.
- To assess the incidence of graft dilation, anastomotic aneurysms, and thrombosis.
Main Methods:
- Computed tomographic evaluation of 52 asymptomatic patients with aortobifemoral bypass grafts.
- Measurement of graft and aortic diameters, and assessment for anastomotic false aneurysms and mural thrombus.
Main Results:
- Significant graft dilation observed: mean 58% in stems and 52% in limbs.
- 15% incidence of anastomotic false aneurysms and 40% incidence of mural thrombus at the anastomosis.
- 92% distal aortic occlusion and potential link between side-to-end anastomosis and complications.
Conclusions:
- End-to-side aortobifemoral bypass anastomoses are associated with significant long-term dilation and adverse events.
- Findings suggest potential risks including anastomotic aneurysms, thrombosis, and graft failure.
- Further research is needed to explore the genesis of these complications and alternative techniques.