Morbidity of femoropopliteal bypass surgery

Weijer, M.A.J. van de; Kruse, R.R.; Schamp, Katja; Zeebregts, Clark J.; Reijnen, Michel M.P.J.

doi:10.1053/j.semvascsurg.2015.09.004

Cited by 59 publications

(36 citation statements)

References 39 publications

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“…Prosthetic grafts are used in the absence of suitable autologous vessels, although they exhibit mildly lower long-term durability, especially with distal vessel location 35,36. Despite high overall patency, femoral–popliteal bypass surgery is associated with a number of complications including lower extremity lymphedema, wound infection, graft occlusion, respiratory failure, acute kidney injury (AKI), stroke, and cardiovascular accident, contributing to a 30-day morbidity rate of 37% 37,38. Identification and prevention of patient risk factors is essential to minimize such high rates of these perioperative complications.…”

Section: Bypass and Expected Outcomesmentioning

confidence: 99%

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Komshian

Pike

et al. 2017

VHRM

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Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0–5.3%), graft failure (12–60%), and amputation (5.7–27%), and more systemic issues include cardiac (2.6–18.4%), respiratory (2.5%), renal (4%), neurovascular (1.5%), and thromboembolic (0.2–1%) complications. While such outcomes present an additional challenge to the postoperative management of surgical patients, it may be possible to minimize their occurrence through careful risk stratification and preoperative assessment. Therefore, individualized selection of candidates for open repair requires weighing the need for intervention against the likelihood of adverse outcomes based on preoperative risk factors. This review provides an overview of open reconstruction, focusing on identifying the clinical indications for surgery and perioperative morbidity and mortality.

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Section: Bypass and Expected Outcomesmentioning

confidence: 99%

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Komshian

Pike

et al. 2017

VHRM

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“…Several studies have reported incidences of SSI after vascular operation between 5% and 10%, mainly in patients with infrainguinal bypass. 16,29 A recent meta-analysis of 38 published articles of the outcomes after femoropopliteal bypass found a mean SSI rate of 7.8%. 30 In our work, these numbers can be explained by the different methodology used because our study included all consecutive patients and involved an active detection of all NIs, especially SSI, including superficial SSI.…”

Section: Discussionmentioning

confidence: 99%

“…This finding could be explained by the possibility of bacterial spread either at the time of operation or later to the surgical area, as suggested by other authors. 29,30 These findings suggest that if the bypass placement is not urgent, surgery should be delayed until the infection is resolved.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and outcomes for nosocomial infection after prosthetic vascular grafts

Fariñas

Campo

Durán

et al. 2017

Journal of Vascular Surgery

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“…31 This is correlated with the inconsistent information related to complications during femoropopliteal bypass surgery, and the overall morbidity can reach 37%. 48 Familiarity with the anatomy of the MGA can decrease the incidence of “never events,” unplanned reoperations, and readmissions. 7,42 …”

Section: Discussionmentioning

confidence: 99%

Relationship Between the Middle Genicular Artery and the Posterior Structures of the Knee

Carvalho

Ramos

Novaretti

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:The middle genicular artery (MGA) is responsible for the blood supply to the cruciate ligaments and synovial tissue. Traumatic sports injuries and surgical procedures (open and arthroscopic) can cause vascular damage. Little attention has been devoted to establish safe parameters for the MGA.Purpose:To investigate the anatomy of the MGA and its relation to the posterior structures of the knees, mainly the posterior capsule and femoral condyles, and to establish safe parameters to avoid harming the MGA.Study Design:Descriptive laboratory study.Methods:Dissection of the MGA was performed in 16 fresh, unpaired adult human cadaveric knees with no macroscopic degenerative or traumatic changes and no previous surgeries. The specimens were meticulously evaluated with emphasis on preservation of the MGA. The distances from the MGA to the medial and lateral femoral condyles were measured. The Mann-Whitney test was used for statistical analysis.Results:In all specimens, the MGA emerged from the anterior aspect of the popliteal artery, distal to the superior genicular arteries, and had a short distal trajectory toward the posterior capsule where it entered proximal to the oblique popliteal ligament. The artery lay in the midportion between the condyles. The distance between the posterior aspect of the tibia and the point of entry of the MGA into the posterior joint capsule was 23.8 ± 7.3 mm (range, 14.72-35.68 mm). There was no correlation between an individual’s height and the distance of the entrance point of the MGA into the posterior joint capsule to the posterior superior corner of the tibia.Conclusion:The middle genicular artery lies in the midportion between the medial and lateral femoral condyles.Clinical Relevance:This knowledge is important for the preservation of the blood supply during posterior knee surgical procedures and to settle a secure distance between the posterior aspect of the tibia and the MGA input. This could decrease and prevent iatrogenic vascular injury risk to the MGA.

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Morbidity of femoropopliteal bypass surgery

Cited by 59 publications

References 39 publications

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Infrainguinal open reconstruction: a review of surgical considerations and expected outcomes

Risk factors and outcomes for nosocomial infection after prosthetic vascular grafts

Relationship Between the Middle Genicular Artery and the Posterior Structures of the Knee

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