Femoro-Supragenicular Popliteal Bypass with a Bridging Stent Graft in a Diffusely Diseased Distal Target Popliteal Artery: Alternative to Below-Knee Popliteal Polytetrafluoroethylene Bypass.
10.5090/kjtcs.2017.50.5.371
- Author:
Joung Hun BYUN
1
;
Tae Gyu KIM
;
Yun Gyu SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Arteries;
Bypass;
Graft;
Stents
- MeSH:
Angiography;
Ankle Brachial Index;
Arterial Occlusive Diseases;
Arteries;
Blood Vessel Prosthesis*;
Extremities;
Follow-Up Studies;
Humans;
Ischemia;
Polytetrafluoroethylene*;
Popliteal Artery*;
Stents*;
Transplants;
Veins
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2017;50(5):371-377
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
