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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

Are peroneal artery bypass grafts hemodynamically inferior to other tibial artery bypass grafts?

K B Raftery1, M Belkin, W C Mackey

  • 1Department of Surgery, New England Medical Center, Tufts University School of Medicine, Boston, MA.

Journal of Vascular Surgery
|June 1, 1994
PubMed

Insights

Peroneal artery bypasses demonstrate comparable hemodynamic results to other infrapopliteal bypasses, supporting their use in limb salvage for patients with ischemic tissue loss.

Area of Science:

  • Vascular Surgery
  • Hemodynamics
  • Reconstructive Surgery

Background:

  • Peroneal artery bypasses are known for excellent long-term patency.
  • Concerns exist regarding their hemodynamic performance compared to other infrapopliteal bypasses for forefoot ischemic tissue loss.

Purpose of the Study:

  • To compare the hemodynamic outcomes of peroneal artery bypass grafts with other infrapopliteal bypasses.
  • To assess the suitability of peroneal bypasses for patients with critical limb ischemia and forefoot tissue loss.

Main Methods:

  • Retrospective review of 118 infrainguinal vein grafts (36 peroneal, 27 anterior tibial, 35 posterior tibial, 20 popliteal).
  • Hemodynamic assessment included preoperative/postoperative ankle-brachial index, transmetatarsal pulse volume recording, distal graft peak systolic flow velocity, and outflow resistance.
  • Comparison with concurrent anterior tibial, posterior tibial, and popliteal artery bypass grafts.

Main Results:

  • No significant differences in postoperative ankle-brachial index, pulse volume recording, peak systolic flow velocity, or outflow resistance were found among the four outflow groups.
  • All peroneal bypass graft patients achieved wound healing within a mean follow-up of 17 months.
  • No hemodynamic failures were observed in the peroneal bypass group.

Conclusions:

  • Peroneal artery bypass grafts provide equivalent hemodynamic results to anterior tibial, posterior tibial, and popliteal artery bypass grafts.
  • These findings support the use of peroneal artery bypasses in limb salvage procedures for patients with critical limb ischemia and forefoot ischemic tissue loss.
Abstract

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