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Endovascular femoropopliteal bypass: a cadaveric study
G E Morris1, S S Ahn, C R Quick
1Addenbrooke's Hospital, Cambridge, U.K.
Summary
This study explored a new endovascular femoropopliteal bypass technique. The novel approach proved feasible in cadaveric limbs, showing potential for treating infra-inguinal occlusive disease.
Area of Science:
- Vascular Surgery
- Endovascular Techniques
- Biomedical Engineering
Background:
- Standard femoropopliteal bypass surgery is the gold standard for infra-inguinal occlusive disease.
- Minimally invasive percutaneous procedures have not yet matched the patency rates of traditional bypass surgery.
Purpose of the Study:
- To assess the feasibility of a novel, less invasive endovascular femoropopliteal bypass technique.
- To evaluate the procedural success and initial graft patency in a cadaveric model.
Main Methods:
- The technique involved endarterectomy of the superficial femoral artery (SFA) and transluminal placement of a PTFE graft.
- Procedures were developed and tested on 48 limbs from 26 fresh human cadavers with varying degrees of SFA disease.
- Key steps included guidewire passage, mechanical dilatation, helical cutter endarterectomy, graft deployment, and anastomosis.
Main Results:
- The endovascular femoropopliteal bypass procedure was successfully completed in 81% (39/48) of the limbs.
- Angiography and explants showed a patent graft and popliteal artery in 62% (24/39) of successful cases.
- Reasons for failure included failed guidewire passage, vessel avulsion, and graft deployment issues.
Conclusions:
- Endovascular femoropopliteal bypass is a feasible technique.
- Further research is warranted to explore its potential clinical application for infra-inguinal occlusive disease.