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femoro peroneal bypass

C Uhl, C Hock, T Betz, S Bröckner, I Töpel, M Steinbauer
BACKGROUND: Endovascular recanalization has become the accepted first-line treatment strategy for most lower extremity arterial occlusions, especially in patients with critical limb ischemia (Rutherford 4-6). Prior endovascular interventions have been described as risk factors for the outcome of subsequent lower extremity bypass surgery. The effect on subsequent tibial and peroneal bypasses is controversial. We analyzed the impact of prior endovascular lower extremity revascularization procedures on the short- and mid-term results of femoro-tibial and femoro-peroneal bypasses...
January 2015: International Journal of Surgery
Nicholas J Gargiulo, Frank J Veith, David J O'Connor, Evan C Lipsitz, William D Suggs, Larry A Scher
BACKGROUND: Composite sequential femoro-popliteal-distal bypass is a valuable option for treatment of critical limb ischemia when autogenous vein is limited and an isolated popliteal or distal arterial segment exists. We report a modified technique for composite sequential bypass and the results with its use over a 14-year period. METHODS: Twenty-five modified composite sequential bypass procedures were performed on 24 patients to treat gangrene, ischemic ulceration, and severe rest pain...
November 2010: Annals of Vascular Surgery
F Gonçalves, H Valentim, H Rodrigues, J M Castro, F A d'Eça, J A Castro, L M Capitão
The introduction of endovascular procedures in the routine of vascular surgery allowed for the expansion of therapeutic options in the diverse areas of vascular disease. Endoluminal revascularization can be regarded as a usefull complement of conventional surgical techniques. An above-knee femoro-popliteal bypass surgery ePTFE graft has been performed, followed by a sheath introduction on the graft body. This allows a simplified access to crural vessels, while providing efficient revascularization of the femoro-popliteal sector...
April 2009: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
B Hugl, A Nevelsteen, K Daenens, M Alonso Perez, P Heider, M Railo, H Schelzig, B Gluecklich, K Balzer, F Vermassen, P De Smit, G Fraedrich
AIM: The Propaten European Product Evaluation (PEPE II) study was a product evaluation intended to characterize the performance of the GORE PROPATEN vascular graft in above-knee (AK) and below-knee bypass (BK) surgery. METHODS: This prospective multicenter trial enrolled 142 patients with peripheral arterial disease. In 87 patients AK and in 52 patients BK bypasses (including 15 femorocrural) were implanted (67.6% males, 32.4% females). RESULTS: The one-year overall primary and secondary patency rates were 80% and 84...
April 2009: Journal of Cardiovascular Surgery
A Eisenschenk, N Noack, M Lautenbach, B Hartmann, M V Küntscher
AIM: The purpose of the study was to establish an algorithm for the reconstruction of soft tissue defects of the distal lower leg, ankle and heel. METHOD: 81 patients presenting with soft tissue defects in these regions underwent flap coverage. The average age was 44.1 years. Small defects (up to 4 x 4 cm) were covered by local flaps. The neurovascular sural flap was the predominant flap procedure for medium size defects (up to 10 x 15 cm). Free flaps were used for larger defects or in cases of stenosis or occlusion of the peroneal artery...
September 2006: Zeitschrift Für Orthopädie und Ihre Grenzgebiete
R Bellosta, L Luzzani, C Carugati, C Melloni, A Sarcina
AIM: The PTFE prosthesis represents an alternative to the autologous saphenous vein in femoro-tibial revascularization for limb salvage in the absence of venous material in the patient. The aim of our study is to confirm the validity of PTFE revascularization and determine the best distal anastomosis in terms of patency using 3 different techniques. We carried out a retrospective analysis, evaluating patients who underwent PTFE femoro-tibial revascularization for critical ischemia. METHODS: Between January 1998 and June 2002 we performed 46 femoro-tibial revascularizations at the Vascular Surgery Division of the Poliambulanza Hospital in Brescia using a PTFE prosthesis, from a total of 192 infrainguinal revascularizations (24%)...
October 2005: Journal of Cardiovascular Surgery
Vikram S Kashyap, Samuel S Ahn, William J Quinones-Baldrich, Byung-Uk Choi, Frederick Dorey, Todd D Reil, Julie A Freischlag, Wesley S Moore
The use of prosthetic conduits for lower extremity revascularization in the infrapopliteal location remains controversial. The objective of this report is to describe the immediate and long-term results in a series collected over two decades. Of the approximately 1,500 lower extremity revascularizations performed between 1978 and 1998, 81 infrapopliteal bypass cases using polytetrafluoroethylene (PTFE) as conduit in 77 patients were identified. Autogenous conduit was unavailable (86%) due to prior surgery: coronary artery bypass graft (25%), femoro-popliteal bypass (60%), or femoro-distal bypass (23%)...
July 2002: Vascular and Endovascular Surgery
J M Duncan, G J Reul, W Aronski, G L Hallman, D A Cooley
Between July 1984 and July 1985, 65 expanded polytetrafluoroethylene grafts (Vitagraft) were implanted in the infrainguinal position in 51 patients, including 41 men and 10 women, with an average age of 63 years. The indications for surgery were severe claudication (36 grafts) or ischemic necrosis of the extremities (29 grafts). Thirteen of the patients (25%) had had a previously placed infrainguinal graft of another type that had failed, requiring reoperation. Proximal vascular reconstruction (consisting of ten aorto-femoral and two femoro-femoral bypasses) was performed in 12 patients who had 16 grafts...
June 1987: Texas Heart Institute Journal
Hussein A Safar, Emad Farid, Hozaifah Nakhi, Sami Asfar
OBJECTIVE: To describe 3 cases of vascular injuries due to orthopaedic procedures. CLINICAL PRESENTATION AND INTERVENTION: Of 242 vascular injuries, 3 were due to orthopaedic screws. The 1st patient presented with a late complication (after 3 years) of an orthopaedic screw placed in close proximity to the axillary artery that with time got eroded and leaked to form a false aneurysm which later caused embolisation to the arm and limb ischaemia. The 2nd and 3rd cases were due acute ischaemia following the orthopaedic procedures...
July 2004: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
D J Parry, D Kessel, D J A Scott
Non-traumatic false aneurysm formation involving the native crural vessels is rare. We present the case of a false aneurysm of the native peroneal artery, which complicated femoro-peroneal bypass grafting. It seemed most likely to be of an infective aetiology, arising as a consequence of contiguous methicillin resistant Staphylococcus aureus wound infection. This was previously unreported in the literature. Successful management was achieved by primary suture, local wound debridement, excision of the distal graft and replacement with an interposition vein graft through uninfected tissue planes...
February 2002: Cardiovascular Surgery: Official Journal of the International Society for Cardiovascular Surgery
V Kniazhev, D Golemanov
A new Russian vascular artificial prosthesis from porous PTFE ("Vitaflon") was used in 39 cases of different obliterative arteriopathy in the critical ischemia phase, moreover in 12 cases with foot gangrene. The diagnoses for all the patients (35 men, 4 women, average age 57.8 years) were made in accordance with the clinical data, arteriography and ultra-sound imaging. In 15 cases the cause of ischemia was thrombo-obliteration of the aorto-femoral and in 24 cases of the femoro-popliteal segments. The following bypass operations were made: aorto-femoral graft implantation in 3 cases, ilio-femoral in 7 and ilio-popliteal in 2 cases, extra-anatomical femoro-femoral bypass graft in 4 cases and axillo-bifemoral in 1 case, femoro-popliteal above the knee bypass in 17 cases, in 2 cases explant-profundi femoral, in 1 case popliteal-peroneal prosthesis and in 2 cases profundoplasty...
2000: Vestnik Khirurgii Imeni I. I. Grekova
P A Stonebridge, S Naidu, M P Colgan, D J Moore, D G Shanik, P T McCollum
UNLABELLED: The combined results of femoro-distal bypasses using prosthetic material with vein cuffs from two separate vascular units is presented. METHOD: Over the last five years, 89 infrainguinal bypasses using polytetrafluoroethylene (PTFE) with a distal interposition vein cuff to a tibial artery have been performed in two centres. All operations were for critical limb ischaemia. The mean age was 72 years (47-90), there were 46 males and 43 females, 27 of whom were diabetic...
February 2000: Journal of the Royal College of Surgeons of Edinburgh
A Cavillon, D Melliere, E Allaire, A E Blancas, D Berrahal, P Desgranges, J P Becquemin
OBJECTIVE: This study was performed in order to determine if: 1-- femoral bypasses ending below the popliteal artery are justified in aged patients or in patients with poor general conditions, 2-- if the use of prosthetic material is justified when no vein is available, 3-- if reintervention is beneficial in case of bypass occlusion. EXPERIMENTAL DESIGN: Retrospective study of 162 infrapopliteal bypasses followed during 1 to 12 years (mean: 1.5). SETTING: Vascular Surgery Department of the University Hospital Henri Mondor based in a suburb of Paris, France...
June 1998: Journal of Cardiovascular Surgery
Z Zhang, Y Marois, R G Guidoin, P Bull, M Marois, T How, G Laroche, M W King
Following positive results obtained in in vitro studies and in vivo implantations in animals, a clinical trial using the Vascugraft polyurethane arterial prosthesis as a below-knee substitute was undertaken in 15 patients. Eight grafts became occluded during the first year, and segments from four of them were explanted and made available for pathological, structural and chemical investigations. The implantation periods ranged from 21 to 358 days. Failures were associated with kinking (one case), possible anastomotic mismatch between the graft and the artery (one case), and poor run-off (two cases)...
January 1997: Biomaterials
P L Harris, A Bakran, L Enabi, D M Nott
Patency rates for long prosthetic bypass grafts with standard anastomoses to single tibial or peroneal arteries are very poor. Adjuvant techniques employed with the aim of improving patency rates include arteriovenous fistula (AVF) at the distal anastomosis to accelerate blood flow above thrombotic threshold velocity (TTV) and a venous cuff (VC) or patch which may reduce or modify anastomotic myointimal hyperplasia within the recipient artery. In a consecutive series of 43 femoro-crural bypasses with ePTFE grafts, adjuvant AVF and VC procedures have been applied in combination...
September 1993: European Journal of Vascular Surgery
J Marzelle, F Cormier, J M Fichelle, J M Cormier
Femoro-tibial bypasses are not always feasible in patients presenting with "critical" chronic ischemia. The results of endovascular therapies carried out over a 2-year period are analyzed. Twenty-three patients with critical ischemia (rest pain 13%, gangrene 87%) had 25 procedures on 29 leg arteries: percutaneous transluminal angioplasty in 17 arteries, rotational atherectomy in 10 arteries, laser recanalization (1 artery), directional atherectomy (1 artery). The hospital mortality rate was 4.3%. The cumulative patency and limb salvage rates were respectively 51% and 77% at 6 months, 34% and 71% at 12 months...
1994: Journal des Maladies Vasculaires
J Marzelle, P Veroux, F Cormier, J M Fichelle, J M Cormier
UNLABELLED: Femoro-distal bypasses are not always feasible in patients presenting with "critical" chronic ischemia. The results of endovascular therapies carried out over a 2-year period were analyzed. PATIENTS--METHODS: 23 patients with critical ischemia (rest pain 13%, gangrene 87%) had 25 procedures on 29 leg arteries; percutaneous transluminal angioplasty in 17 arteries, rotational atherectomy in 10 arteries, laser recanalization (1 artery), directional atherectomy (1 artery)...
1993: Journal des Maladies Vasculaires
P Gouny, P Bertrand, B Decaix, C Hocquet-Cheynel, B Karcenty, M Chemla, O Nussaume
Revascularization for chronic lower extremity ischemia in patients of 80 years and older is controversial. To better define operative risk and outcome after peripheral vascular procedures in the elderly, our experience from January 1990 to December 1992 was reviewed. We compared two groups of patients: group I with 26 patients (28 revascularizations) 80 years of age and older (84 +/- 3 years) and group II with 29 patients (32 revascularizations) younger than 80 years (70 +/- 8 year). The two groups were similar with regard to risk factors, surgical indication (rest pain and/or gangrene) and type of graft (in situ vein: 35, reversed vein: 12, PTFE: 13)...
October 1994: Journal of Cardiovascular Surgery
Y Kubo, T Sasajima, T Atsuta, H Ikeda, Y Nishioka, Y Izumi, M Inaba, M Matsushita, N Samejima
Fifty-six reconstructions using Biograft were performed in 45 cases with peripheral arterial occlusion. These consisted of 11 femoro-popliteal bypasses above the knee, 19 femoro-popliteal below the knee, 10 femoro-tibial or peroneal and 16 other miscellaneous procedures including aorto-femoral and extra-anatomic bypasses. Overall patency rates for each type of procedure were 81.8%, 78.9%, 30.0%, and 93.8%, respectively. The cumulative patency rate (calculated by the life table method) for the total group was 70...
March 1983: Journal of Cardiovascular Surgery
T Sasajima
The author has studied glutaraldehyde stabilized human umbilical cord vessels (PHUV) both experimentally and clinically since Nov. 1976. The experimental findings showed that the PHUV is not organized and its patency depends on the blood compatibility of the fibrin net and blood flow. The histologic examination of the graft wall revealed a slight inflammatory response consisting of macrophages and occasional foreign body giant cells around the Dacron mesh but with very little reaction in the umbilical vein itself...
January 1984: Nihon Geka Gakkai Zasshi
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