Long-Term Results of Obturator Bypass

Hara, Masaki; Tabuchi, Atsushi; Yunoki, Yasuhiro; Kuwata, Noriaki; Tamura, Taishi; Honda, Takeshi; Takiuchi, Hiroki; Yamasawa, Takahiko; Furukawa, Hiroshi; Kurabayashi, Masahiko; Tanemoto, Kazuo; Watanabe, Yoshinori

doi:10.3400/avd.oa.15-00085

Cited by 14 publications

(18 citation statements)

References 6 publications

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“…Several studies have indicated that obturator bypass is a durable method with a cumulative patency rate of 76–88% at 24 months. 8,9 Moreover, our study demonstrated excellent long-term patency and limb salvage. In comparison, other types of extra-anatomic bypass procedures for inguinal infection have less favorable long-term patency.…”

Section: Discussionsupporting

confidence: 58%

“…The PTFE graft is a commonly used conduit for obturator bypass. 6,8,9 In inguinal graft infection, the majority of patients have occlusive arterial disease and requires bypass surgery with a length of more than 40 cm. In addition, the conduit needs support against extrinsic compression caused by hip flexion and an extra-anatomical course through the thigh muscles.…”

Section: Discussionmentioning

confidence: 99%

“…Although a cryopreserved arterial allograft or autologous femoral vein graft may be used for graft infection, a ringed polytetrafluoroethylene (PTFE) graft with better radial force is generally considered to improve long-term patency and limb salvage. 8,9 Here, we investigated the long-term clinical outcomes of obturator bypass using a ringed PTFE graft for inguinal graft infection at a single center.…”

Section: Introductionmentioning

confidence: 99%

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Obturator bypass using a ringed polytetrafluoroethylene graft for inguinal graft infection

et al. 2020

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Objective Inguinal vascular graft infections are high-risk events that cannot be controlled medically but require surgical intervention. This study reviewed the long-term clinical outcomes of obturator bypass using a ringed polytetrafluoroethylene graft for inguinal graft infection. Methods A total of eight consecutive patients who underwent obturator bypass using a ringed polytetrafluoroethylene graft for inguinal prosthetic graft infection at a single medical center between January 2006 and October 2017 were retrospectively analyzed. The demographics, clinical characteristics, surgical procedure, and clinical outcomes were evaluated. Results There was no perioperative death; however, there were three operative complications. On the 1st and 9th postoperative day, two patients underwent hematoma evacuation in the pelvic cavity, and the other patient underwent suture reinforcement for partial dehiscence of the distal anastomosis on the 49th postoperative day. The median length of hospital stay was 14.5 (range, 7–29) days. Only one graft occlusion was observed at postoperative month 40; however, there were no ischemic symptoms. There were no limb amputations and postoperative deaths during the long-term follow-up period. There were no infections of the previous residual and obturator bypass grafts and inguinal infection during the follow-up period of 49 (range, 7–154) months. Conclusion Obturator bypass for inguinal graft infection is feasible and durable with excellent long-term outcomes. However, perioperative bleeding should be taken into consideration.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Obturator bypass using a ringed polytetrafluoroethylene graft for inguinal graft infection

et al. 2020

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“…17) We did not always attempt graft salvage by MFC in patients with PGIs. If a patient was able to tolerate the invasive surgery, the infected graft was excised, and subsequent revascularization [18][19][20] was added whenever possible. This most desirable treatment was also performed if graft salvage by MFC or NPWT failed or if graft infection recurred.…”

Section: Discussionmentioning

confidence: 99%

Salvage of Infected Prosthetic Grafts at the Groin or Thigh Using Muscle Flap Coverage

Tanaka

Mii

Ishida

et al. 2020

Annals of Vascular Diseases

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Objectives: This study aimed to evaluate early-and longterm outcomes in patients who undergo muscle flap coverage (MFC) for prosthetic graft infections (PGIs) at the groin or thigh. Materials and Methods: We retrospectively retrieved and analyzed data on infected wound cures, recurrence, graft and limb salvage, and survival of patients who underwent MFC for PGI at the groin or thigh between 2000 and 2018. Results: There were eight patients in our cohort: six had groin PGIs and two had thigh PGIs. Moreover, of these patients, seven were treated from sartorius muscles and one from a gracilis muscle. The indicated wounds healed in all eight patients, but two patients died during hospitalization. Three patients suffered recurrence within 8 months, one of which overcame the infection and achieved wound cure without graft removal, with negative pressure wound therapy. No patients lost their limbs during the follow-up term (mean, 24 months; range, 1-60 months). Finally, four patients (50%) survived without removal of the infected graft for longer than 2 years. Conclusion: MFC can be a curative treatment for PGI, but there remains a possibility of a recurring infection thereafter.

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“…The obturator bypass has advantages in cases of groin infection as the deep route of an obturator bypass circumvents infected fields as well as a shorter graft length. In literature review, extraperitoneal or transperitoneal approaches as well as varying conduit type with either autologous vein or synthetic grafts such as PTFE are encountered; however, we present a case for an obturator bypass with bovine carotid conduit and explantation of infected femorofemoral bypass graft [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Obturator Bypass with Bovine Carotid Artery Graft: A Novel Twist to a Traditional Technique

Brown

Esper

Henwood

2019

Case Reports in Surgery

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When managing an infected groin, though rarely performed, a transobturator bypass remains an important alternative in the armament of a vascular surgeon. Autologous vein and synthetic PTFE are known conduit options for obturator bypasses, although the advantage of utilizing an autologous biological conduit when dealing with infection may not be an option for every patient. On literature review, bovine carotid grafts have been used in infrainguinal revascularizations with comparable results to autologous vein; however, no cases can be found for its use in obturator bypass thus far.

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Long-Term Results of Obturator Bypass

Cited by 14 publications

References 6 publications

Obturator bypass using a ringed polytetrafluoroethylene graft for inguinal graft infection

Obturator bypass using a ringed polytetrafluoroethylene graft for inguinal graft infection

Salvage of Infected Prosthetic Grafts at the Groin or Thigh Using Muscle Flap Coverage

Obturator Bypass with Bovine Carotid Artery Graft: A Novel Twist to a Traditional Technique

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