Comparison of Long-term Outcomes of Heparin Bonded Polytetrafluoroethylene and Autologous Vein Below Knee Femoropopliteal Bypasses in Patients with Critical Limb Ischaemia

Uhl, Christian; Grosch, C.; Hock, Carolin; Töpel, I.; Steinbauer, Markus

doi:10.1016/j.ejvs.2017.05.001

Cited by 29 publications

(16 citation statements)

References 19 publications

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“…In a study comparing the saphenous vein and ePTFE grafts in peripheral bypasses in the lower limb, the limb salvage rate was 90% in the saphenous vein group and 62.9% in the ePTFE group. [12] This ratio was 69.4% in the saphenous vein group and 55% in the ePTFE group for male patients.…”

Section: Discussionmentioning

confidence: 88%

Our surgical experiences on vascular injuries in Afrin Olive Branch operation

Özgüler¹

2019

Turk J Vasc Surg

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Objectives: In this study, we present our surgical experiences on vascular injuries during the Afrin Olive Branch operation of Turkey. Patients and methods: Between February 2018 and May 2018, a total of 37 traumatized patients (36 males, 1 females; mean age 26.8 years; range, 17 to 55 years) with vascular injuries who were treated by cardiovascular surgeons during the Afrin Olive Branch operation were included in this study. Results: A total of 37 patients underwent 46 vascular surgical procedures. There were no surgery-related mortalities during follow-up. Twenty patients (54%) were discharged and 17 patients (46%) were transferred to an external center in the postoperative early period. Conclusion: Based on our experiences, we suggest that major arterial injuries should be repaired rather than direct amputation, and the saphenous vein must be used for bypass or interposition, where applicable.

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Section: Discussionmentioning

confidence: 88%

Our surgical experiences on vascular injuries in Afrin Olive Branch operation

Özgüler¹

2019

Turk J Vasc Surg

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“…These published results are mainly in accordance with our findings, as 56% of the patients reached the combined endpoint of overall and flap survival after a median follow‐up time of 53 months (range 0‐151) in our study. In comparison, patency rates of femoro to distal (below the knee) vein bypasses are reported to be 75.3% after 12 months and 51.7% after 5 years in patients with CLI …”

Section: Discussionmentioning

confidence: 99%

Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up

Rother

Müller‐Mohnssen

Lang

et al. 2019

International Wound Journal

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Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long-term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single-centre institution were included. During follow-up examination, the patency of arterial reconstruction was investigated by duplex ultrasound. Flap micro-circulation was assessed by laser Doppler flowmetry and white light tissue spectrometry (O2C) as well as by indocyanine green fluorescence angiography. Twentythree patients could be clinically followed up. Duplex ultrasound showed, in four cases, arterial pedicle occlusion in spite of vital flap. Comparison of the O2C perfusion parameters between flaps with occluded pedicles and those with intact inflow showed no significant difference (parameters sO2: P = .82; Flow: P = .31). Similar results were obtained by fluorescence angiography; no significant difference could be detected between both groups (parameters Ingress P = .13; Ingressrate P = .54). Combined vascular reconstruction with free tissue transfer is associated with a good long-term outcome and wound closure. Even after flap transplantation to areas with critical tissue perfusion, the flap can develop autonomy and thus survive after pedicle occlusion.

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“…Arterial reconstruction was accomplished by means of a flow-through flap in six cases (►Fig. [1][2][3], and of an arterial graft in one case (►Figs. 4-6).…”

Section: Methodsmentioning

confidence: 99%

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

Toia

Zabbia

Roggio

et al. 2017

J reconstr Microsurg

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Background The use of vascular grafts is indicated in case of insufficient pedicle length or for complex defects involving both soft tissues and vessels. Venous grafts (for both venous and arterial reconstructions) and arterial grafts (arterial reconstruction) can be used. This study retrospectively evaluated the needs for vascular reconstruction and its results in a clinical series of lower limb reconstructions with microsurgical free flaps. Materials and Methods From 2010 to 2015, a total of 16 vascular grafts or flow-through flaps were used in 12 patients out of a total of 150 patients undergoing microsurgical reconstruction (8%). Arterial reconstruction was performed in seven cases (six flow-through flaps, one arterial graft), combined arterial and venous reconstruction in four cases (three vein grafts, one combined venous/arterial graft), and venous reconstruction in one case (one venous graft). The rate of complications and donor-site morbidity related to vascular graft harvest were evaluated. Results Reconstruction was successful in all cases, despite an overall complication rate of 17 and 8% of surgical revision. Donor-site morbidity, subjectively evaluated, was minimal with respect to functional deficits and aesthetic outcome. Indications for the different types of grafts are discussed. Conclusion The use of vascular grafts is needed in a relevant percentage of microsurgical reconstruction cases. Venous and arterial vascular grafts, transient arteriovenous fistulas, and “flow-through” microsurgical flaps showed a safe reconstruction comparable to microsurgical reconstructions without the use of grafts. Donor-site morbidity secondary to vascular graft harvest is minimal, and in almost 70% of cases no additional scars are needed.

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Comparison of Long-term Outcomes of Heparin Bonded Polytetrafluoroethylene and Autologous Vein Below Knee Femoropopliteal Bypasses in Patients with Critical Limb Ischaemia

Abstract: Bypasses to the below knee popliteal artery show good results in patients with CLI unsuitable for endovascular therapy. Vein is still the first line graft material.

Cited by 29 publications

References 19 publications

Our surgical experiences on vascular injuries in Afrin Olive Branch operation

Our surgical experiences on vascular injuries in Afrin Olive Branch operation

Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long‐term follow‐up

Vascular Grafts and Flow-through Flaps for Microsurgical Lower Extremity Reconstruction

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