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Published on: January 11, 2016
[Femoro-crural in situ bypass]
J E Lorentzen1, T Schroeder, J Aabech
1Abteilung für Gefässchirurgie, Rigshospitalet, Universität Kopenhagen.
Insights
This study shows that the in situ femoro-crural bypass technique effectively salvages limbs threatened by ischemia, achieving high patency and survival rates compared to reversed vein grafts.
Area of Science:
- Vascular Surgery
- Arterial Reconstruction
- Peripheral Artery Disease
Context:
- Limb-threatening ischemia necessitates urgent surgical intervention.
- Obstructive disease of crural arteries poses a significant challenge in vascular reconstruction.
- The in situ bypass technique is a specialized surgical method for arterial reconstruction.
Purpose:
- To evaluate the efficacy of the in situ femoro-crural bypass technique.
- To compare the outcomes of in situ bypass with the reversed vein technique.
- To assess limb salvage and graft patency rates in patients with critical limb ischemia.
Summary:
- 108 in situ femoro-crural bypass procedures were performed for limb-threatening ischemia.
- The distal anastomosis was performed in a crural or pedal artery in 102 patients.
- 97% of patients had salvaged limbs, with 76% one-year patency and 90% one-year limb survival.
Impact:
- The in situ technique demonstrated superior results compared to the reversed vein technique.
- This study highlights the effectiveness of in situ bypass for limb salvage in critical ischemia.
- Improved limb salvage and patency rates can significantly enhance patient quality of life.
Abstract:
During a period of 21 months from April 1986, 108 in situ femoro-crural bypass procedures were performed. The indication for surgery was in all cases a limb threatening ischemia. Always the technique described by Leather et al. was used. All the patients had obstructive disease of the crural arteries, thus the distal anastomosis was performed in a single crural or pedal artery for 102, and for 40 at the level of the ankle or foot. 97 per cent of the patients were discharged from the hospital with a salved limb, the one year patency was 76 per cent and one year limb survival 90 per cent. In our hands the in situ technique has shown much better results than the reversed vein technique.
