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Composite sequential bypass using profunda vein hitchhike.

Radhakrishnan Raju1, Kapil Mathur1, Makkathai Kanakasabai Ayyappan1

  • 1Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India.

Journal of Vascular Surgery
|October 21, 2016
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Summary

This study introduces a novel technique using the profunda vein as a hitchhike point for bypass surgery in patients with critical limb ischemia. This method offers excellent short-to-medium term outcomes for a challenging patient subgroup.

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Area of Science:

  • Vascular Surgery
  • Reconstructive Surgery
  • Ischemia Management

Background:

  • Long-segment iliac and femoral artery occlusions often require sequential bypass.
  • A subset of patients lacks suitable groin vessels for traditional bypass.
  • Critical limb ischemia necessitates innovative surgical solutions.

Purpose of the Study:

  • To evaluate the efficacy of using the profunda vein as a hitchhike point for arterial bypass.
  • To assess outcomes in patients with iliac/aortic occlusions and absent groin inflow.
  • To present a new surgical technique for a challenging vascular reconstruction.

Main Methods:

  • Seven patients (eight limbs) with critical ischemia underwent bypass using the profunda vein as a hitchhike point.
  • Proximal graft anastomosis to the profunda vein, which was ligated proximally.
  • Distal saphenous vein graft anastomosed to tibial arteries.

Main Results:

  • The profunda vein hitchhike technique was technically successful in all cases.
  • Median follow-up was 8 months (range 0-30 months).
  • Excellent short and medium-term outcomes were observed.

Conclusions:

  • The profunda vein hitchhike technique is a viable option for specific patients with critical limb ischemia.
  • This method provides a successful reconstructive solution when groin vessels are unavailable.
  • It offers excellent outcomes in this uncommon patient population.