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The Journal of Cardiovascular Surgery 1998 June;39(3):295-301

language: English

Extra-ana­tom­ic ­bypass sur­gery for crit­i­cal leg ische­mia. A ­review

Biancari F., Lepantalo M.*

From the III Department of Surgery University “La Sapienza”, Rome, Italy
* Division of Vascular Surgery Department of Surgery Helsinki University Central Hospital, Helsinki, Finland


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Since an aggres­sive revas­cu­lar­isa­tion pol­i­cy for crit­i­cal ­limb ische­mia (CLI) has ­been ­shown to low­er mor­bid­ity and mor­tal­ity, to ­improve qual­ity of ­life and to be ­cost-effec­tive in com­par­i­son to ampu­ta­tion, ­extra-ana­tom­ic ­bypass (EAB) ­grafts may be indi­cat­ed when­ev­er hos­tile ­local con­di­tions or ­severe med­i­cal dis­eas­es con­tra­in­di­cate an aor­tof­e­mo­ral recon­struc­tion. Most ­series ­report ­limb-sal­vage ­rates mark­ed­ly high­er ­than the relat­ed paten­cy ­rates, as revas­cu­lar­isa­tions may ­often ­heal the ischem­ic extrem­ity ­before the ­graft ­occludes. A ­large ­review of ­data ­from the lit­er­a­ture sug­gests ­that EAB graft­ing for CLI may ­achieve grat­i­fy­ing ­results in a sub­group of ­patients ­with mul­ti­lev­el obstruc­tive dis­ease and not suit­able for con­ven­tion­al aor­tof­e­mo­ral ­repair.

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