Retroperitoneal aortofemoral bypass using a reversed L-shaped prosthesis

Area of Science:

• Vascular Surgery
• Surgical Techniques
• Abdominal Aorta Surgery

Background:

• The transperitoneal approach for aortofemoral bypass has historically been standard.
• Limitations of the transperitoneal approach include potential for increased morbidity and longer recovery times.

Purpose of the Study:

• To evaluate the efficacy and superiority of an extraperitoneal approach for aortofemoral bypass.
• To compare the outcomes of the extraperitoneal approach with the traditional transperitoneal method.

Main Methods:

• A novel extraperitoneal incision starting from the eleventh rib to the femoral artery was utilized.
• A reversed L-shaped prosthesis was employed, connecting the aorta to the left femoral artery and extending to the right femoral artery.
• The same incision was adapted for aortoiliac endarterectomy.

Main Results:

• The extraperitoneal approach demonstrated superiority over the transperitoneal approach for aortofemoral bypass.
• The reversed L-shaped graft proved more effective than the Y graft for iliac artery replacement.
• Fifteen patients with occlusive disease and twenty-one with aneurysms underwent successful procedures.

Conclusions:

• The extraperitoneal approach for aortofemoral bypass is a simpler, faster procedure with reduced morbidity and accelerated recovery.
• This technique is also suitable for aortoiliac endarterectomy.
• The reversed L-shaped prosthesis via an extraperitoneal route offers significant advantages in vascular reconstruction.