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A Rabbit Venous Interposition Model Mimicking Revascularization Surgery using Vein Grafts to Assess Intimal Hyperplasia under Arterial Blood Pressure

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Genesis of Crural Revascularization.

Thomas R Bernik¹, Melissa Montoya¹, Brian M Leoce¹

¹Department of Vascular Surgery, Englewood Hospital and Medical Center, Englewood, NJ.

Annals of Vascular Surgery

|February 23, 2019

Summary

Pioneering surgeons advanced limb salvage through crural bypass surgery between 1960-1979, achieving significant patency rates. These foundational open procedures remain vital alongside modern endovascular techniques for successful limb preservation.

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Area of Science:

Vascular Surgery
Limb Salvage Procedures
Arterial Revascularization

Background:

Focuses on historical development of crural bypass for limb salvage when distal arterial blockage is limited to crural vessels.
Highlights the evolution of crural bypass amidst the rise of endovascular interventions.

Observation:

Reviews literature from 1960-1979 to identify pioneers in infrageniculate revascularization.
Documents patency and amputation rates from early distal limb bypass series.
Separately records cases from the era not published until the 1980s.

Findings:

Analyzed 746 crural bypasses performed between 1960-1979.
Reported 6-, 12-, and 36-month patency rates of 76%, 59%, and 48%, respectively.
Observed an overall amputation rate of 17% during this period.

Implications:

Early crural bypass procedures demonstrated satisfactory progress, paving the way for future refinements.
Recognizes the enduring importance of historical open surgical techniques in limb salvage.
Emphasizes the complementary role of established bypass surgery with contemporary endovascular methods.