Bypass to the perigeniculate collateral vesselsA useful technique for limb salvage: Preliminary report on 22 patients

Abstract

These early results appear promising with a 1-year primary patency rate of 77%, assisted primary patency rate of 85%, and a limb-salvage rate of 90% according to the Kaplan-Meier life-table method. This technique is particularly useful when adequate length saphenous vein is not available, no other outflow vessels are available, or other outflow vessels are very calcified and not safely clamped. The continued study of the long-term effectiveness is warranted.

Sural Artery Bypass in Buerger's Disease: Report of a Case

“…Barral et al used the medial artery, which is surrounded by a venous plexus that is carefully freed down to the level at which the artery descends into the gastrocnemius muscle. 2) This muscle can be mobilized and divided for 1 to 2 cm to allow the exposure of an additional 3 to 4 cm of artery. One of the advantages of this procedure is that this allows the surgeon to completely avoid below-the-knee incisions, which are more likely to present wound-healing difficulties.…”

“…10) It seemed that SPP may be one of the assisted predictors of quality of the perfusion of the sural artery bypass before the ulcer recurrence. Barral et al reported that bypass to a perigeniculate vessel alone may not be sufficient to allow tissue healing in the patient with extensive foot necrosis, 2) and such patients may require a more distal bypass to achieve limb salvage. However, the perigenicular artery bypass can be a valid option for limb salvage in selected patients with no calcification in the diseased arteries.…”

“…Previous studies have described bypass to the perigeniculate collateral arteries as an option for limb salvage in selected patients, such as in cases of extensive disease, previous failed endo-or open vascular attempts, lack of the usual crural arterial runoffs or autogenous substitutes being common scenarios. [1][2][3][4][5][6][7] However, the use of this bypass has been restricted to a few groups of vascular surgeons. This report presents one case of a successful sural artery bypass in a patient with Buerger's disease, who presented with rest pain in the leg due to occlusion of the previous distal bypass.…”

Surgical revascularization on buerger's disease patients: A twelve-year experience

“…In the last twenty years however, new possibilities were found and many limitations were avoided after new methods, such as a microvascular surgical technique (including optical magnifying, microsurgical instruments and thinner sutures), ''in situ'' bypass and Esmarch's-technique, have been clinically tested and applied widely [4,5,11,15,22]. The ''in situ'' technique, for example, showed excellent results and saved the limbs in 11 of our patents.…”

Successful Arterial Reconstruction with Collateral Artery Bypass for a Femoral Artery Aneurysm: Report of a Case

“…In infrainguinal revascularization for critical limb ischemia, Barral et al advocated using perigeniculate collateral vessels as outflow tracts when no other outflow vessels are available, or when other outflow vessels are highly calcified and not safely clamped. 6 Shindo et al also suggested that collateral artery bypass is an option when the main arteries are affected by Buerger's disease. 7 We reported this case to highlight that the collateral arteries are a viable option for runoff vessels in the treatment of femoral aneurysms complicated by thromboembolic obstruction of the outflow arteries.…”