Comparison of Above-Knee and Below-Knee Anastomosis in Femoropopliteal Bypass Grafts

Brewster, David C.

doi:10.1001/archsurg.1981.01380200023004

Cited by 44 publications

(3 citation statements)

References 15 publications

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“…In addition, excluded patients had underwent below-knee FEM-POP bypass surgery and patients underwent operation using saphenous vein graft can be controversial. Because it is well known that clinical outcomes of above-knee FEM-POP bypass is better than below-knee FEM-POP bypass and also saphenous vein graft had the better patency than PTFE graft especially below-knee FEM-POP bypass, 7,8 it was very difficult to analyze the exact factors and effects in detail if we include the patients who had underwent below-knee FEM-POP bypass surgery and patients had underwent operations using saphenous vein. That is why we had exclusion criteria strictly.…”

Section: Resultsmentioning

confidence: 99%

Can concomitant above-knee femoropopliteal bypass with artificial graft affect the outcome of femorofemoral bypass with artificial graft?

Kim

Cha

2021

Vascular

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Objectives Few have studied the effect of concomitant femoropopliteal (FEM-POP) bypass surgery on the outcome of femorofemoral (FEM-FEM) bypass in patients with peripheral arterial disease (PAD). This study was aimed to analyze the risk relationship of concomitant FEM-POP bypass on the patency of FEM-FEM bypass. Methods From March 2009 to April 2020, a total of 27 patients who underwent FEM-FEM bypass surgery using polytetrafluoroethylene grafts were retrospectively analyzed according to concomitant FEM-POP bypass surgery. The mean follow-up duration was 38.20 ± 34.56 months. Results The overall primary patency of the FEM-FEM bypass grafts in all 27 patients was 83.7, 78.5, and 72.0 at one, two, and 3 years, respectively. The overall limb salvage rate was 100, 94.1, and 86.9 at one, two, 3 years, respectively. Among them, ten patients underwent FEM-FEM bypass only (group 1). The other 17 patients needed a concomitant FEM-POP bypass and these patients were classified into three groups (group 2, ipsilateral FEM-POP, n = 5; group 3, crossover FEM-POP, n = 6; and group 4, bilateral FEM-POP, n = 6) The comparison of the primary patency of group 1 with the concomitant FEM-POP groups (sum of groups 2, 3, and 4, that is, group 5, n = 17) revealed a statistically significant improved patency for FEM-FEM bypasses not requiring concomitant infra-inguinal bypass ( p = .036). Among the concomitant FEM-POP groups, group 2 had the lowest primary patency of the FEM-FEM bypass significantly ( p = 0.07). The limb salvage rate of group 4 was significantly low. Conclusions A concomitant FEM-POP bypass influenced the outcome of FEM-FEM bypass surgery. In conclusion, compromised infra-inguinal runoff at either extremity requiring concomitant FEM-POP bypass significantly worsens long-term FEM-FEM bypass patency. In addition, a concomitant bilateral FEM-POP bypass is a risk factor affecting the limb salvage rate in FEM-FEM bypass.

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Section: Resultsmentioning

confidence: 99%

Can concomitant above-knee femoropopliteal bypass with artificial graft affect the outcome of femorofemoral bypass with artificial graft?

Kim

Cha

2021

Vascular

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“…Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease (PAOD). Experienced surgeons have raised concerns about whether the optimal location of distal anastomosis is AK or below-knee (BK) [ 1 ]. Previous studies have reported that synthetic grafts are considered acceptable alternatives for femoral-AK popliteal bypass procedures, unlike femoral-BK popliteal bypass procedures [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Generally, the patency of BK polytetrafluoroethylene (PTFE) bypass grafts is inferior to that of AK PTFE bypass grafts [ 1 , 9 , 10 ]. Moreover, long superficial femoral artery (SFA) occlusion may sometimes occur with a diffusely diseased distal target popliteal artery or if BK bypass surgery is impossible due to conditions such as a skin wound at the incision site.…”

Section: Introductionmentioning

confidence: 99%

Femoro-Supragenicular Popliteal Bypass with a Bridging Stent Graft in a Diffusely Diseased Distal Target Popliteal Artery: Alternative to Below-Knee Popliteal Polytetrafluoroethylene Bypass

Byun

Kim

Song

2017

Korean J Thorac Cardiovasc Surg

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BackgroundLesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease.MethodsBetween April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications.ResultsAll procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks.ConclusionIn AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.

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Femoropopliteal and Tibioperoneal Artery Reconstruction Using Human Umbilical Vein

Robison¹,

Brewster²,

Abbott³

et al. 1983

Arch Surg

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Comparison of Above-Knee and Below-Knee Anastomosis in Femoropopliteal Bypass Grafts

Cited by 44 publications

References 15 publications

Can concomitant above-knee femoropopliteal bypass with artificial graft affect the outcome of femorofemoral bypass with artificial graft?

Can concomitant above-knee femoropopliteal bypass with artificial graft affect the outcome of femorofemoral bypass with artificial graft?

Femoro-Supragenicular Popliteal Bypass with a Bridging Stent Graft in a Diffusely Diseased Distal Target Popliteal Artery: Alternative to Below-Knee Popliteal Polytetrafluoroethylene Bypass

Femoropopliteal and Tibioperoneal Artery Reconstruction Using Human Umbilical Vein

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