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Extraanatomic bypass for peripheral arterial injuries.

D V Feliciano1, K D Accola, J M Burch

  • 1Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas.

American Journal of Surgery
|December 1, 1989
PubMed
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Extraanatomic bypass grafting effectively treated peripheral arterial injuries and infections in 12 patients. This technique preserved arterial flow and allowed wound closure in most cases.

Area of Science:

  • Vascular Surgery
  • Trauma Surgery
  • Reconstructive Surgery

Background:

  • Peripheral arterial injuries and infections pose significant reconstructive challenges.
  • Previous arterial repairs can rupture, especially in cases of infection.
  • Illicit drug use is a notable cause of combined soft tissue and arterial infections.

Purpose of the Study:

  • To evaluate the efficacy of extraanatomic bypass grafting for complex peripheral arterial injuries and infections.
  • To assess the technique's utility in cases of extensive soft tissue loss or infected arterial wounds.
  • To determine the outcomes of using autogenous saphenous vein for extraanatomic bypass in challenging vascular reconstructions.

Main Methods:

  • Extraanatomic bypass grafting using autogenous saphenous vein was performed in 12 patients over 8 years.

Related Experiment Videos

  • Indications included extensive soft tissue loss, infected arterial ruptures, and drug-injection-related infections.
  • The procedure involved excising the compromised artery and routing the graft around the wound.

    • Main Results:

    • Successful wound closure and preservation of distal arterial flow were achieved in 11 out of 12 patients.
    • Shotgun wounds accounted for six injuries, while brachial artery involvement was seen in eight patients.
    • Five patients had residual neuromuscular or bony defects secondary to the initial trauma.

    Conclusions:

    • Extraanatomic bypass grafting is a viable option for managing complex peripheral arterial injuries and infections.
    • The technique facilitates wound healing and restores essential arterial circulation in challenging scenarios.
    • Despite successful revascularization, associated tissue defects may require further management.