New routing alternative for proximal anterior tibial artery bypass in patients with Buerger disease

Abstract

Femoral-anterior tibial artery bypasses with autogenous grafts are difficult to perform when sufficiently long saphenous veins are not available. We performed 12 bypasses on patients with Buerger disease during a 20-year period using a new intermuscular tunneling technique. The graft is passed from the thigh between the muscle compartments without penetrating the muscle fibers, providing an anatomically superior and shorter path. The primary patency rates were 75% at 5 years and 65% at 10 years. We believe that our tunneling technique is safe and durable and might be a viable alternative for proximal femoral-anterior tibial artery bypass in selected patients.

Systemic Diseases Affecting Liver Vessels

“…It has been hypothesized that cholestasis result from ischaemic injury and cytokine release. Some cases report demonstrated noncaseating epithelioid cell granulomatous inflammation of medium-sized arterioles within the portal tracts and disruption of the elastic laminae [53,54]. Liver involvement does not seem to impact the prognosis of giant cell arteritis.…”

Thromboangiitis Obliterans

“…Cumulative patency was 70 % (7 of 10) for saphenous vein grafts, 50 % (3 of 6) for polytetrafluoroethylene grafts, and 33.3 % (1 of 3) for composite grafts. Different distal bypass techniques and routes have been described to obtain better anatomical orientation and patency rates in patients with TAO [178][179][180]. Successful local flap transfers after distal bypass surgery have been reported in selected cases [181][182][183][184].…”