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The Journal of Cardiovascular Surgery 2001 October;42(5):651-6

language: English

Popliteo-distal and tibio-tibial bypasses: a viable alternative for the revascularisation of the critically ischaemic limb

Moñux Ducajú G., Serrano Hernando F. J., Sanchez Hervás L.

From the Vascular Surgery Hospital Universitario San Carlos Universidad Complutense, Madrid, Spain


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Background. The aim of the ­present ­study was to eval­u­ate ­graft paten­cy and ­limb sal­vage ­rates of pop­li­teo-dis­tal and ­tibio-tibi­al bypass­es per­formed for crit­i­cal ischae­mia of the low­er ­limb.
Methods. Thirty ­short bypass­es per­formed dur­ing a ­five-­year peri­od (1994-1998) ­were ­reviewed. The ­inflow ­source was the suprag­e­nic­u­lar pop­li­teal ­artery in 14 ­patients, the infra­ge­nic­u­lar pop­li­teal ­artery in 12 ­patients and a tibi­al ­artery in four ­patients. Distal out­flow was to a ped­al ves­sel in 14 ­patients, and ­above the mal­le­o­lus in 16 ­patients. Autogenous ­vein was ­used as con­duit (saph­e­nous ­vein in 28 ­patients and cephal­ic ­vein in two ­patients).
Results. Operative mor­tal­ity was 3.3%. Early ­graft paten­cy and ­limb sal­vage ­rates ­were 90 and 93%, respec­tive­ly. Late pri­mary and sec­on­dary paten­cy, and ­limb sal­vage ­rates ­were 77%, 80 and 76% at 12 ­months, and 71, 74 and 76% at 24 ­months, respec­tive­ly. These ­rates ­showed no dif­fer­enc­es attrib­ut­able to dia­betes, ­inflow or out­flow ­site, sur­gi­cal tech­nique or ­slight prox­i­mal involve­ment. There was no pro­gres­sion of dis­ease in the super­fi­cial femo­ral ­artery, ­even in the pres­ence of mod­er­ate pre­op­er­a­tive ­lesions.
Conclusions. Popliteo-dis­tal and ­tibio-tibi­al bypass­es are dur­able pro­ce­dures ­which ­yield ­good ­bypass paten­cy and ­limb sal­vage ­rates.

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