Graft type for femoro-popliteal bypass surgery

Twine, Christopher P.; McLain, Alexander D

doi:10.1002/14651858.cd001487.pub2

Cited by 87 publications

(82 citation statements)

References 50 publications

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“…Some specifi ed procedures have been agreed being primarily suitable for surgical repair: • Complex lesion and coexisting severe renal failure, which may cause irreversible renal failure, if high amount of contrast agent is needed for endovascular intervention Autologous vein grafts provide best patency results and should be used whenever available [39] (LoR A).…”

Section: Critical Limb Ischaemiamentioning

confidence: 99%

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

Lawall

Huppert

Espinola‐Klein

et al. 2017

Vasa

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Summary:The prevalence of peripheral artery disease (PAD) is increasing worldwide and is strongly age-related, affecting about 20 % of Germans over 70 years of age. Recent advances in endovascular and surgical techniques as well as clinical study results on comparative treatment methods strengthened the need for a comprehensive review of the published evidence for diagnosis, management, and prevention of PAD. The interdisciplinary guideline exclusively covers distal aorta and atherosclerotic lower extremity artery disease. A systematic literature review and formal consensus fi nding process, including delegated members of 22 medical societies and two patient self-support organisations were conducted and supervised by the Association of Scientifi c Medical Societies in Germany, AWMF. Three levels of recommendation were defi ned, A = "is recommended/ indicated", B = "should be considered", C = "may be considered", means agreement of expert opinions due to lack of evidence. Altogether 294 articles, including 34 systematic reviews and 98 RCTs have been analysed. The key diagnostic tools and treatment basics have been defi ned. In patients with intermittent claudication endovascular and/or surgical techniques are treatment options depending on appropriate individual morphology and patient preference. In critical limb ischaemia, revascularisation without delay by means of the most appropriate technique is key. If possible and reasonable, endovascular procedures should be applied fi rst. The TASC classifi cation is no longer recommended as the base of therapeutic decision process due to advances in endovascular techniques and new crural therapeutic options. Limited new data on rehabilitation and follow-up therapies have been integrated. The article summarises major new aspects of PAD treatment from the updated German Guidelines for Diagnosis and Treatment of PAD. Limited scientifi c evidence still calls for randomised clinical trials to close the present gap of evidence.Keywords: Peripheral artery disease, diagnosis, treatment, update, guideline update fi cation [2] has been the basis of the therapeutic decision process for the last decade. Its four types A-B-C-D classify peripheral atherosclerotic vascular lesions of increasing length and complexity. According to TASC, type A and B lesions were recommended to be treated endovascular-fi rst, type C and D lesions were typically fi rst addressed for surgical repair. With increasing experience of intervention and advanced stent technologies, such as drug eluted and covered stent grafts of increasing lengths, bifurcational stents, and covered angioplasty catheters, the endovascular procedures recently have become increasingly successful. Patients request non-surgical procedures as an alternative approach without risk of narcosis and lower invasive character. A renunciation from the TASC guided approach has become the consequence of the scientifi c literature evaluation.

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Section: Critical Limb Ischaemiamentioning

confidence: 99%

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

Lawall

Huppert

Espinola‐Klein

et al. 2017

Vasa

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“…12, 13 The primary patency rate of bypass surgery was significantly higher than that for EVT, especially when autologous vein graft was used, while some studies have reported increased duration of hospitalization and some cases of wound infection after bypass surgery. 14, 15 There was a clear primary patency benefit for use of autologous vein as compared to synthetic materials for above-knee bypass. 16 Furthermore, avoidance of dual antiplatelet drugs is more advantageous in patients who have undergone bypass surgery than in those receiving stent placement with respect to preventing future bleeding.…”

Section: Outcome Of Evt Vs Bypassmentioning

confidence: 99%

Comparison of Long-Term Outcome After Endovascular Therapy Versus Bypass Surgery in Claudication Patients With Trans-Atlantic Inter-Society Consensus-II C and D Femoropopliteal Disease

Aihara

Soga

Mii

et al. 2014

Circ J

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on behalf of the RECANALISE Registry Investigators Background: Although endovascular therapy (EVT) has advanced, few reports have compared EVT and bypass surgery in claudication patients with femoropopliteal disease. The present study used data from a multicenter registry in Japan to analyze outcomes of EVT and bypass surgery for claudication patients with Trans-Atlantic InterSociety Consensus (TASC)-II C and D femoropopliteal lesions. Methods and Results:Of 1,156 patients who underwent revascularization, 696 patients were treated for intermittent claudication. A total of 263 patients with femoropopliteal lesion were classified into TASC-II C and D. The primary and secondary patency rates of the EVT and bypass surgery groups were analyzed. The overall complication rate was 14.4% in the bypass surgery group and 3.5% in the EVT group (P<0.01). The 1-and 5-year primary patency rates were 82.1% and 69.4% in the bypass surgery group and 67.8% and 45.2% in the EVT group, respectively. Although the bypass surgery group had a higher primary patency rate than the EVT group (P<0.01, log-rank test), secondary patency rates did not differ significantly between the two groups. Conclusions:Although bypass surgery is clearly feasible for claudication patients with TASC-II C and D femoropopliteal disease, EVT is also a good option because of its lower complication rate and good secondary patency rate in patients in poor condition for bypass. (Circ J 2014; 78: 457 -464)

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“…Some studies stated that the primary patency rate of bypass surgery was considerably higher than endovascular treatment in femoropopliteal arterial diseases [12,13]. The endovascular treatment can be the first choice in the case of poor condition [14].…”

Section: Discussionmentioning

confidence: 99%

İliyak arter ve infrainguinal arter tıkayıcı hastalığında hybrid strateji

Sarıçam¹,

Sağlam²,

Beton³

et al. 2017

TURKISH JOURNAL of CLINICS and LABORATORY

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Aim:The treatment of peripheral arterial disease has encompassed different therapy options. Hybrid therapy method (endovascular treatment plus surgery) has recently been used in lower extremity arterial disease. This study has examined hybrid therapy practice in iliac and infrainguinal arterial disease. Materials and Methods: This study included 76 patients with occlusive iliac artery disease and performed iliac artery endovascular treatment from January 2010 to August 2015. While 56 patients underwent only iliac artery stenting, 20 of 76 patients underwent additionally infrainguinal vascular surgery (hybrid therapy).Results: In 20 hybrid patients group, iliac artery lesion length was 31.0 ± 7.6 mm. Seven patients had TASC-II A iliac artery class, while 13 patients had TASC-II B class. According to femoropopliteal lesions, eight patients had TASC-II C, while 12 patients had TASC-II D. One patient died in postoperative period. Graft stenosis developed in one patient, which was resolved through catheter therapy. In the one-year follow-up, in one patient, iliac stent restenosis developed, ABI was 0.91 ± 0.20. Conclusion:Hybrid therapy is a feasible option for multilevel lower extremity artery disease, including iliac artery disease and TASC-II C or D femoropopliteal disease. This technique has favorable patency with lower complication rates.

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Graft type for femoro-popliteal bypass surgery

Cited by 87 publications

References 50 publications

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016

Comparison of Long-Term Outcome After Endovascular Therapy Versus Bypass Surgery in Claudication Patients With Trans-Atlantic Inter-Society Consensus-II C and D Femoropopliteal Disease

İliyak arter ve infrainguinal arter tıkayıcı hastalığında hybrid strateji

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