Axillopopliteal bypass for limb salvage

Keller, Michael P.; Hoch, John R.; Harding, Alfred D.; Nichols, W. Kirt; Silver, Donald

doi:10.1016/0741-5214(92)90716-l

Cited by 19 publications

(6 citation statements)

References 8 publications

(2 reference statements)

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“…Ascer et al [7] have reported a series of 55 cases of axillo-popliteal bypass with 5-year patency rate of 40 % and operative mortality rate of 8 %, Keller et al [8] have reported 41 cases with 3-year patency rate of 43 % and operative mortality rate of 20 %, Bastounis E et al [9] in their series of 67 cases of axillo-popliteal and axillodistal bypass have reported 5-year primary patency of 13 %, other series include less than 10 cases individually. Indications for axillo-popliteal bypass in these series were failed aortofemoral grafts, graft infection, and severe atherosclerotic Fig.…”

Section: Discussionmentioning

confidence: 97%

Axillo-popliteal bypass with sequential graft to femoral artery in a case of aorto-iliac occlusive disease with calcified abdominal aorta and iliac vessels

Goyal

Chaudhary

Soni

et al. 2014

Indian J Thorac Cardiovasc Surg

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Section: Discussionmentioning

confidence: 97%

Axillo-popliteal bypass with sequential graft to femoral artery in a case of aorto-iliac occlusive disease with calcified abdominal aorta and iliac vessels

Goyal

Chaudhary

Soni

et al. 2014

Indian J Thorac Cardiovasc Surg

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“…Despite encouraging results achieved by some authors 11,14,36 in using the extra-anatomical femorofemoral or axillofemoral bypass as an inflow procedure, we reserve this approach only for very high-risk patients.…”

Section: Discussionmentioning

confidence: 99%

“…Kram et al 16 presents a 78% five-year limb salvage rate after unilateral aortofemoropopliteal distal bypass. Keller et al, 36 presenting with 30 patients after axillopopliteal bypass, demonstrated a 69% limb salvage rate after three years. Ellenby et al 14 presented with a 77% limb salvage rate at five years in a group of 21 patients after femorofemoropopliteal bypass.…”

Section: Discussionmentioning

confidence: 99%

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Simultaneous Versus Two–Stage Multisegmental Reconstruction for Critical Lower Limb Ischemia

Zukauskas

Ulevicius

1995

Ann Saudi Med

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Treatment of critical limb ischemia (CLI) remains one of the most demanding problems of vascular surgery, especially when it is due to multisegmental occlusive arterial disease. Three main options of treatment are accepted: inflow procedure alone, simultaneous inflow and outflow reconstructions, or two-stage surgery. To compare the results of the latter two was the aim of this study. During a six year period from 1987 to 1992, 1953 aortofemoral reconstructions were performed. In 245 cases (12.5%), sequential aortofemorodistal (popliteal or tibial) procedures were necessary for successful treatment of CLI -Grade III and IV Fountain. In 161 cases, twosegment reconstruction was performed in one stage (Group A), and in 84 cases (Group B), two separate operations were done -outflow procedure followed after the inflow surgery. Results in perioperative and remote postoperative periods were analyzed regarding limb salvage and graft patency rates using a life table method. Perioperative mortality was 3% in Group A and 6% in Group B. The limb salvage rate was 95.6% at one year and 90.4% at five(A), and 88.8% and 80% (B) respectively. Primary overall graft patency rate was 91.4% at one year and 65.5% at five (A) and 84.9% and 59.4% (B) respectively. Secondary graft patency was 92.2% at one year and 81.8% at five (A) and 86.1% and 65.9% (B

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“…Retrospectively, in this patient, as the second operation, a supplementing extra-anatomical bypass grafting and resection of affected femoral artery with closure of the stumps should have been performed soon after recovery from shock condition, at the latest, within 7-10 days after the first operation, and a lateral femoral bypass or axillo-popliteal bypass grafting 10) could have been an appropriate procedure in this patient because extension of metastatic tumor to the obturator foramen was found on CT and during the operation.…”

Section: Discussionmentioning

confidence: 99%

A Case of Femoral Arterial Bleeding by an Unknown Origin Metastatic Groin Lymph Nodes Carcinoma

Nakamura

Oda

Yasunaga

et al. 2016

Annals of Vascular Diseases

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We report a case of femoral arterial bleeding complicated with hemorrhagic shock caused by bacterial infection attributed to an inguinal lymph node metastasis of carcinoma of unknown primary. Because of severe preoperative condition, a venous patch plasty of ruptured artery, and omentopexy for the groin was performed as a less invasive surgery. But the recurrence of bleeding was occurred postoperatively. A staged operation, hemostasis with a venous patch plasty at a first stage, and an extra-anatomical bypass soon after improvement of shock condition in a second stage, can be one of surgical procedures to save the lives and salvage limbs. Keywords: femoral arterial bleeding, groin lymph nodes, groin infectionIn this paper, we report a case of femoral arterial bleeding caused by bacterial infection attributed to an inguinal lymph node metastasis of a CUP in an elderly patient. Case ReportA 79-year-old man was emergently transferred to our hospital for treatment of pulsatile massive bleeding from the eroded ulceration in the left groin with hemorrhagic shock. He noticed swelling of the lymph nodes in the left groin 15 months previously, and then the patient was diagnosed with metastatic carcinoma of the lymph nodes, which was pathologically classified as squamous cell carcinoma (SCC), after biopsy of the affected lymph node. Despite of close examinations using extensive diagnostic procedures, which included measurement of tumor markers, ultrasonography, computed tomography (CT), magnetic resonance imaging, gastrointestinal endoscopy, and combined 18 F-fluorinefluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT), the primary origin was not identified. FDG-PET showed high levels of FDG uptake in the left groin but significant FDG uptake was not detected in any other site such as the abdomen, the genitals and the lower extremities (Fig. 1). Based on these findings, a diagnosis of CUP with inguinal lymph node metastasis was made, and radical inguinal lymphadenectomy was judged to be difficult. Then, the patient underwent radiation therapy, but it was not effective to suppress expansion of the metastatic lymph node carcinoma. During the following 7 months, the expanded metastatic lymph node carcinoma eroded the skin with occurrence of ulceration, infection, and femoral vessel involvement. A small amount of bleeding from the ulceration repeatedly occurred during the last 4 months. CT performed one month previously revealed the large, irregular and poorly bordered mass extended from left pelvic region to the left groin with necrosis of its central part with involvement of the iliac and femoral arteries and a fistula to the skin ( Fig. 2A). Thrombosis of the left femoral and iliac veins and cancerous invasion to the pelvis were also demonstrated on CT (Figs. 2B, 2C). On admission, the patient was in circulatory collapse

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Axillopopliteal bypass for limb salvage

Cited by 19 publications

References 8 publications

Axillo-popliteal bypass with sequential graft to femoral artery in a case of aorto-iliac occlusive disease with calcified abdominal aorta and iliac vessels

Axillo-popliteal bypass with sequential graft to femoral artery in a case of aorto-iliac occlusive disease with calcified abdominal aorta and iliac vessels

Simultaneous Versus Two–Stage Multisegmental Reconstruction for Critical Lower Limb Ischemia

A Case of Femoral Arterial Bleeding by an Unknown Origin Metastatic Groin Lymph Nodes Carcinoma

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