Femorotibial bypass for claudication: Do results justify an aggressive approach?

Conte, Michael S.; Belkin, Michael; Donaldson, Magruder C.; Baum, Patricia; Mannick, John A.; Whittemore, Anthony D.

doi:10.1016/s0741-5214(95)70214-8

Cited by 46 publications

(27 citation statements)

References 13 publications

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“…13, 14 In the present study, one-third of tibial artery bypasses with a vein graft cases were performed using a spliced vein graft, which greatly decreased the patency rate of the vein graft. The percentage of composite grafts with a vein in the report of Conte et al was 2.7%, 6 and Byrne et al 5 reported that 70% in-situ vein grafts and 30% excised vein grafts were used in their study. The primary and SP rates of a single saphenous vein graft in the present study were 71% and 89%, respectively at 5 years.…”

Section: Morbidity and Mortalitymentioning

confidence: 88%

“…5,10,11 However, with respect to tibial artery bypass for IC, there are only 2 reports of the long-term results. 5, 6 Byrne et al reported 5-year patency rates of 79% for primary and 83% for SP after surgical bypass with a vein graft 5 and Conte et al reported 5-year patency rates of 81% for PP and 86% for SP after surgical bypass. 6 No operative death or MA was described in either report.…”

Section: Discussionmentioning

confidence: 99%

“…5, 6 Byrne et al reported 5-year patency rates of 79% for primary and 83% for SP after surgical bypass with a vein graft 5 and Conte et al reported 5-year patency rates of 81% for PP and 86% for SP after surgical bypass. 6 No operative death or MA was described in either report. The long-term patency of tibial artery bypass in those reports 5,6 was equivalent to those of bypass with a more proximal artery taget.…”

Section: Discussionmentioning

confidence: 99%

“…Age and ABI were calculated as continuous variables; the hazard ratio of age and ABI was measured per 10 reports have demonstrated the long-term results of tibial artery bypass for IC. 5, 6 The aim of this study, the first English report regarding tibial artery bypass for IC in Japan, is to review the results of infragenicular bypasses targeting the below-knee popliteal (BKPOP) and tibial artery and consider the reasonable indications for tibial artery bypass as a strategy for IC. The clinical records of patients were prospectively collected in a database and retrospectively analyzed.…”

Section: Risk Factor Assessmentmentioning

confidence: 99%

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Raison d’etre of Tibial Artery Bypass for Intermittent Claudication in the Era of Endovascular Therapy

Mii¹,

Tanaka

Kyuragi

et al. 2016

Circ J

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Background: There is currently no positive opinion regarding infrapopliteal revascularization for intermittent claudication (IC) in any guidelines. The aim of this study was to analyze the outcomes of infragenicular bypass and verify the adequacy of tibial artery bypass for IC. Methods and Results:Over a 21-year period, 58 below-knee popliteal artery (BKPOP) bypasses and 35 tibial artery bypasses were performed for IC caused by arteriosclerosis obliterans. Graft patency and major amputation (MA) were examined as primary endpoints and the predictor of each outcome was estimated by multivariate analysis. The primary patency (PP), secondary patency (SP), and freedom from MA (ffMA) rates of a prosthetic/vein graft in all cases at 5 years were 19/68%, 22/86%, and 78/100% (P<0.01 in all). Limited to vein graft cases, PP and SP rates of popliteal/tibial bypass at 5 years were 73/62% (P=0.32) and 92/80% (P=0.22), respectively. In tibial artery bypass with a vein graft, the PP and SP rates of a single saphenous vein/spliced vein graft at 5 years were 71/46% (P=0.11) and 89/61% (P=0.03). A prosthetic graft was a common negative predictor for graft patency and MA by multivariate analysis. Conclusions:Tibial artery bypass is an acceptable treatment option for IC when a single saphenous vein can be harvested as a graft conduit. (Circ J 2016; 80: 1460 -1469

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Section: Morbidity and Mortalitymentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Risk Factor Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Raison d’etre of Tibial Artery Bypass for Intermittent Claudication in the Era of Endovascular Therapy

Mii¹,

Tanaka

Kyuragi

et al. 2016

Circ J

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“…Prosthetic vascular grafts seeded with genetically modified canine endothelial cells, derived from autologous vein, were found to express the transgene 5 weeks after implantation. In the same year, Nabel and colleagues locally infused genetically modified endothelial cells following ilio-femoral arterial injury in a porcine model with transgene expression being evident at 4 weeks (Nabel et al, 1989).Following proof of principle that autologous endothelial cells could be delivered to native vasculature after injury (Nabel et al, 1989), a series of studies were undertaken to evaluate the effect of venous cell delivery upon arterial structure and function (Berinyi et al, 1992;Thompson et al, 1993;Conte et al, 1994;Thompson et al, 1994;Conte et al, 1995). Reimplantation of cells after arterial injury was associated with enhanced endothelialization.…”

mentioning

confidence: 99%

Defining the potential for cell therapy for vascular disease using animal models

Gulati

Simari

2009

Disease Models &Amp; Mechanisms

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132Vascular cell delivery PERSPECTIVE sources would provide. Two major issues must be considered with regard to mature endothelial cells. First, will they have the plasticity to affect a therapeutic endpoint, and second have they been altered as a result of the underlying disease process. Nonetheless, multiple sources of mature endothelial cells exist. Venous endothelium has been harvested and used to populate biomaterial or synthetic vascular grafts (Herring et al., 1978;Graham et al., 1979;Belden et al., 1982;Noishiki et al., 1990a;Noishiki et al., 1990b;Noishiki et al., 1992), although endothelial cells may be quite limited in these settings (Zilla et al., 1987).Adipose tissue contains two potent sources of endothelial cells, namely resident microvascular endothelial cells and adipose-derived stromal cells (Miranville et al., 2004;Planat-Benard et al., 2004;Fraser et al., 2006;Wosnitza et al., 2007;Traktuev et al., 2008). In humans, the former may be defined as CD34+/CD45-cells that express CD31 and CD144. The adipose-derived stem cells (CD34+/CD45-/CD31-) share many properties with marrow stromal cells, are capable of endothelial differentiation, and are found in close proximity to endothelial cells (ECs) within adipose tissue.Given differences in endothelial cell phenotype and function according to tissue, matching the cell source to the intended cell phenotype may be important. For example, microvascular endothelial cells derived from tissues such as adipose may be relevant for therapeutic angiogenesis, given their highly proliferative nature and higher tube-forming capacity compared with large artery endothelial cells. By contrast, using arteryderived endothelial cells for relocation to another arterial system might be advantageous given the relatively poor ability to form new capillaries. Highly angiogenic cells might in theory promote adventitial and neointimal proliferation, promoting plaque expansion. In addition, large arterial endothelial cells express much higher amounts of the anti-atherosclerotic protein endothelialspecific nitric oxide synthase (eNOS) compared with microvascular endothelium (Gulati et al., 2003a). However, clinical applications of this approach may be limited by access to large arterial tissue.The ability to generate cells with an endothelial phenotype from peripheral blood would greatly simplify the harvesting process. In 1963 Stump and colleagues (Stump et al., 1963) demonstrated that endothelial colonies could be generated on small patches of Dacron within the lumen of an aortic interposition graft, which led the authors to postulate circulating blood as the endothelial source. Modern studies of animal and human chimeras using genetic markers and tagging have revealed that bone marrow-derived circulating progenitors may contribute to both endothelial and intimal smooth muscle cell formation in multiple models of vascular injury (Shi et al., 1998;Sata and Walsh, 2003).Asahara's landmark paper suggested that a CD34+ circulating cell subset contained endothelial precursor cells ...

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Outcome and cost analysis after femorocrural and femoropedal grafting for critical limb ischaemia

Panayiotopoulos¹,

Tyrrell²,

Owen³

et al. 1997

Br. J. Surg.

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The patency rate of femorotibial and peroneal bypass depends on the inflow state, the availability of a venous conduit, the number of calf vessels, the presence of straight flow to the foot and the presence of patent pedal vessels. These factors can help in the selection of patients for femorodistal reconstruction and may explain the wide variation in published results. The low cost of revascularization compared with amputation justifies attempted reconstruction. However, repeated attempts to reconstruct patients with severe distal disease who may benefit more from primary amputation will significantly increase the cost.

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Femorotibial bypass for claudication: Do results justify an aggressive approach?

Cited by 46 publications

References 13 publications

Raison d’etre of Tibial Artery Bypass for Intermittent Claudication in the Era of Endovascular Therapy

Raison d’etre of Tibial Artery Bypass for Intermittent Claudication in the Era of Endovascular Therapy

Defining the potential for cell therapy for vascular disease using animal models

Outcome and cost analysis after femorocrural and femoropedal grafting for critical limb ischaemia

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