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Extra-anatomic reconstruction

J F McKinsey1

  • 1Department of Surgery, University of Chicago, Illinois, USA.

The Surgical Clinics of North America
|August 1, 1995
PubMed
Summary
This summary is machine-generated.

Extra-anatomic bypass grafts are valuable for specific patients, but their expanded use over direct aortobifemoral bypass is not supported by current patency rates. Vascular surgeons should retain them for selected cases.

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Effective hemodynamic diameter: an intrinsic property of vein grafts with predictive value for patency.

Journal of vascular surgery·2000

Area of Science:

  • Vascular Surgery
  • Surgical Outcomes
  • Graft Patency

Background:

  • Extra-anatomic bypass grafts offer solutions for infected surgical fields, hostile abdomens, and limited life expectancy.
  • These grafts can serve as temporary conduits during definitive treatment of infections.
  • Their expanded role requires critical evaluation against direct revascularization methods.

Purpose of the Study:

  • To critically evaluate the expanded role of extra-anatomic bypass grafts compared to direct aortobifemoral artery bypass.
  • To assess the efficacy and long-term outcomes of extra-anatomic bypasses in vascular surgery.

Main Methods:

  • Comparative analysis of outcomes between extra-anatomic bypass grafts (specifically axillofemoral) and direct aortobifemoral bypass grafts.
  • Review of existing literature on postoperative mortality, myocardial infarction rates, and graft patency.

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Main Results:

  • Aortobifemoral bypass exhibits lower postoperative mortality (3-5%) and myocardial infarction rates (2%) with higher 5-year primary patency (80-92%).
  • Axillofemoral bypass grafts show a significantly lower 5-year primary patency rate (50-73%).

Conclusions:

  • The current patency data do not support expanding the use of extra-anatomic bypass grafts in place of aortobifemoral bypass for generally healthy patients.
  • Extra-anatomic bypasses remain crucial for managing selected patient populations and should be part of a vascular surgeon's toolkit.