Optimal conduit choice for open lower extremity bypass in chronic limb-threatening ischemia

Thomas, Jessica; So, Kristine L.; Turner, Jason Ty; Malanowski, Alexander J.; Colvard, Benjamin

doi:10.1053/j.semvascsurg.2022.05.001

Cited by 7 publications

(3 citation statements)

References 45 publications

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“… 14 The use of cryopreserved allografts has been widespread in vascular and transplant surgery. In vascular surgery, cryovein allografts have been used in limb salvage bypass procedures, 15 , 16 dialysis access, and arterial and venous reconstruction in various abdominal procedures. 17 , 18 When used for lower extremity infrageniculate bypass, 1 and 3 year patency are reported in the 37% and 24% range, respectively, with revisional surgery needed in a significant minority.…”

Section: Discussionmentioning

confidence: 99%

Case Report: The Use of Cryopreserved Saphenous Vein in Reconstruction of Transplant Renal Artery Dissection

Hwang,

Moritz

2023

Transplantation Direct

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Section: Discussionmentioning

confidence: 99%

Case Report: The Use of Cryopreserved Saphenous Vein in Reconstruction of Transplant Renal Artery Dissection

Hwang,

Moritz

2023

Transplantation Direct

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“…17 LEB is one of the most durable procedures performed for claudicants. 18 Overall, claudication represents a unique opportunity for smoking intervention owing to the nonacute nature of the condition compared with acute limb ischemia. In acute limb ischemia, LS takes immediate priority and smoking cessation discussions are important postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes after lower extremity bypass in the actively smoking claudicant

Patel,

Zarrintan,

Jagadeesh

et al. 2023

European Journal of Vascular and Endovascular Surgery

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“…As recently reported in the Global Vascular Guidelines, vein bypass should be preferred for patients with advanced limb threat and high-complexity disease in cases of low-intermediate surgical risk [1]; however, the optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery [1]. Several studies highlight that, for below-the-knee revascularization, the great saphenous vein (GSV) should be the firstchoice conduit, thanks to its greater long-term patency and lower infectious risk compared to the use of prosthesis bypass (PTFE) [7][8][9][10]. However, according to the literature, in 20-40% of the cases, the GSV is unavailable because it has been previously excised or is unsuitable [11,12].…”

Section: Introductionmentioning

confidence: 99%

External Scaffold for Venous Graft to Treat Chronic Limb-Threatening Ischemia: Results of the FRAME Vascular Support

Montelione,

Catanese,

Nenna

et al. 2024

JCM

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Background: The surgical treatment of chronic limb-threatening ischemia and optimal conduit choice are extensively debated. The presence of suboptimal autologous material, such as varicosities or venous aneurysms, might impair long-term outcomes. Therefore, kink-resistant external supports have been advocated in the recent literature to improve the conduit quality and outcomes. This study analyzes the FRAME external support in venous ectasic grafts in patients with chronic limb-threatening ischemia. Methods: From September 2017 to September 2023, a total of sixteen patients underwent CLTI surgery with FRAME external support for venous grafts. The inclusion criteria for FRAME applications were varicose or ectasic autologous material with a diameter ≥ 4.5 and ≤ 8 mm in an isolated segment or in the entire vein and a higher risk of bypass extrinsic compression (e.g., extra-anatomical venous bypass course). Results: Technical success and intraoperative patency were achieved in all cases. At 30 days, the limb salvage and survival rates were 100%. The primary bypass patency was 93.7% due to an early graft occlusion. No graft infection was registered. In one case, dehiscence of the surgical wound was treated by surgical debridement and antibiotic therapy. Minor amputation was required in four patients. Over a median follow-up of 32 months, two occlusions were observed; one was treated with reoperation and the other with major amputation. The primary patency was 68.7% and the assisted primary patency was 75%. Limb salvage rates observed during the entire follow-up period were 87.5%. No graft infections or dilatation of the reinforced veins were registered. Conclusions: For patients with CLTI undergoing infrainguinal bypass, satisfactory results in terms of patency and limb salvage rates were achieved using the autologous venous material, even if ectasic or varicose, with the vascular external support FRAME.

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Optimal conduit choice for open lower extremity bypass in chronic limb-threatening ischemia

Cited by 7 publications

References 45 publications

Case Report: The Use of Cryopreserved Saphenous Vein in Reconstruction of Transplant Renal Artery Dissection

Case Report: The Use of Cryopreserved Saphenous Vein in Reconstruction of Transplant Renal Artery Dissection

Long-term outcomes after lower extremity bypass in the actively smoking claudicant

External Scaffold for Venous Graft to Treat Chronic Limb-Threatening Ischemia: Results of the FRAME Vascular Support

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