Infrapopliteal Bifurcated Dual Run-off Bypass in Critical Limb Ischemia: A Report of 2 Cases

Okazaki, Jin; Ishida, Masaru; Kuma, Sosei; Morisaki, Koichi

doi:10.1016/j.avsg.2015.01.024

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…In their two reported cases, they handled this dilemma by performing bifurcated dual runoff bypass. 32 This added a secondary outflow channel to the original bypass outflow, and achieved successful perfusion. An alternative approach in these heavily calcified cases is to modify the lesion by endovascular methods and thereby prepare the target artery for bypass anastomosis.…”

Section: Multiple Outflowmentioning

confidence: 99%

Lower extremity revascularization via endovascular and surgical approaches: A systematic review with emphasis on combined inflow and outflow revascularization

Mustapha¹,

Anose

Martinsen

et al. 2020

SAGE Open Medicine

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This review is intended to help clinicians and patients understand the present state of peripheral artery disease, appreciate the progression and presentation of critical limb ischemia/chronic limb-threatening ischemia, and make informed decisions regarding inflow and outflow endovascular revascularization and surgical treatment options within the context of current debates in the medical community. A controlled literature search was performed to obtain research on outcomes of critical limb ischemia patients undergoing complete leg revascularization for peripheral artery disease inflow and outflow disease. Data for this review were identified by queries of medical and life science databases, expert referral, and references from relevant papers published between 1997 and 2019, resulting in 48 articles. The literature review herein indicates that endovascular revascularization—including ballooning, stenting, and atherectomy—is an effective peripheral artery disease therapy for both above the knee and below the knee disease, and can safely and effectively treat both inflow and outflow disease. As such, it plays a leading role in the therapy of lower extremity artery disease.

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Section: Multiple Outflowmentioning

confidence: 99%

Lower extremity revascularization via endovascular and surgical approaches: A systematic review with emphasis on combined inflow and outflow revascularization

Mustapha¹,

Anose

Martinsen

et al. 2020

SAGE Open Medicine

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“…Dual distal bypass will be useful under certain conditions, 6 , 7 although we believe that a single peripheral anastomosis will usually be sufficient for distal bypass, as we previously reported. 8 In the present patient, EVT was performed over the whole pedal arch, including the anastomosis sites.…”

Section: Discussionmentioning

confidence: 56%

Novel combination therapy of pedal arch angioplasty and dual distal bypass as an alternative treatment option for vasculitis in patients with chronic limb-threatening ischemia

Yamamoto¹,

Komai²,

Sakashita³

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…18 Several case reports on BB emphasize technical aspect without mid-or long-term results of patency and AFS rate. [7][8][9] Spillerova et al published a paper on angiosome revascularization and assessed that indirect revascularization leads to significantly worse wound healing rates compared with direct revascularization, although 'in bypass surgery this concept is of less value and the artery with the best run off should be selected as the outflow artery'. The 1-year AFS rate achieved is only 18.0% for indirect revascularization bypass and 20.3% for direct ones.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the use of BB for CLTI has been published as anecdotal cases and never focused on angiosome concept. 8,9 Little is known concerning the safety and effectiveness of this approach in terms of mortality and morbidity rates, amputation-free survival (AFS), graft primary (PP) and primary assisted patency (PAP) at early and midterm follow-up.…”

Section: Introductionmentioning

confidence: 99%

Bifurcated bypass in severe chronic limb threatening ischaemia

Adami

Marconi

Piaggesi³

et al. 2021

Vascular

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Objectives Revascularization according to the angiosome concept is of proven importance for limb salvage in chronic limb threatening ischaemia but it is not always practicable. Bifurcated bypasses could be considered as an option when an endovascular approach is not feasible or has already failed and a single bypass would not allow direct revascularization of the ischaemic area. Bifurcated bypasses are characterized by landing on two different arteries, the main artery (in direct continuity with the foot vessels) and the secondary one (perfusing the angiosome district). The aim of this study is to evaluate the safety and effectiveness of bifurcated bypass in chronic limb threatening ischaemia. Methods Thirty-five patients were consecutively treated with a bifurcated bypass for chronic limb threatening ischaemia from January 2014 to December 2019 in a single vascular surgery centre. Data from clinical records and operative registers were collected prospectively in an electronic database and retrospectively analysed. Primary and primary assisted bypass patency, amputation-free survival, morbidity and mortality rates at 12 and 24 months were analysed. Results Mean follow-up period was 25.1 months (range 2–72 months). Thirty-six bifurcated bypasses were performed on 35 patients (age 75.3 ± 7.2 years; 69.4% were male). According to Wound, Ischemia, foot Infection classification 22.2% belonged to stage 3 and 77.8% to stage 4 and the mean Rutherford’s class was 5.1 ± 0.7. Immediate technical success was 100%. Early mortality and morbidity rates were respectively 5.5%, and 33.3%; foot surgery was performed in 50% of cases with wound healing in all patients. Primary patency and primary assisted bypass patency were 96.7% and 100% at 6 months; 85.2% and 92% at 12 months, 59.9% and 73.4% at 24 months, respectively. Amputation-free survival at 12 and 24 months was, respectively, 95.6% and 78.8%. Overall survival rates at 12 and 24 months were respectively 94.4% and 91.6%. Conclusions Bifurcates bypass can provide good results in patients with chronic limb threatening ischaemia without endovascular option, especially in diabetic ones. Bifurcated bypass is a complex surgical solution, both to be planned and performed, and it is quite invasive for frail patients that should be accurately selected.

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Infrapopliteal Bifurcated Dual Run-off Bypass in Critical Limb Ischemia: A Report of 2 Cases

Cited by 3 publications

References 9 publications

Lower extremity revascularization via endovascular and surgical approaches: A systematic review with emphasis on combined inflow and outflow revascularization

Lower extremity revascularization via endovascular and surgical approaches: A systematic review with emphasis on combined inflow and outflow revascularization

Novel combination therapy of pedal arch angioplasty and dual distal bypass as an alternative treatment option for vasculitis in patients with chronic limb-threatening ischemia

Bifurcated bypass in severe chronic limb threatening ischaemia

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