Peroneal Artery Bypass: A Multifactorial Analysis

Infrapopliteal arterial revascularization for critical limb ischemia: Is the peroneal artery at the distal third a suitable outflow vessel?

“…17 On the other hand, our patency and LS rates correlate well with the only previouslypublished study dealing with the terminal PA being used in primary or secondary distal revascularizations for CLI because a more proximal outflow vessel was unavailable: 23 in a series of 159 revascularizations performed in 143 patients during a 14-year period, Darling et al 23 reported 1-and 5-year SP rates of 86% and 75%, respectively, with a 5-year LS rate of 87%, demonstrating that these reconstruction procedures achieved much the same hemodynamic results as PT or DP, and PB bypass grafts. Revascularizations to the distal third of the PA were also found as reliable in effecting LS as the proximal two thirds of the PA or other perimalleolar arteries in the same investigators' hands, 1,5,8,10 and their results were comparable with those obtained by many authors advocating the use of PA bypass procedures for LS, though none of them specifically focused on the terminal PA. [2][3][4]6,7,9 In our study, the mean time to wound healing and the proportion of wounds completely healed during the follow-up were similar after distal PA or inframalleolar and PBs bypasses, despite a significantly higher incidence of 26 we found that the lateral approach to the PA provides excellent exposure of the PA distal tract, and, in our opinion, it is quicker and easier than the medial approach.…”

“…[11][12][13][14] The PA is relatively spared from the terminal stages of atherosclerosis 1,15 and is often the last tibial vessel to become occluded in diabetes or end-stage vascular disease. 1,2 The main prejudice, on the other hand, against its use in distal revascularizations is that perfusion of the foot is indirect, via collaterals from its anterior and posterior branches, despite an extensive collateral arterial bed, so the target vessel may be inadequate for treating a septic or gangrenous foot. 11,13,16,17 Inframalleolar vessels include the posterior tibial (PT) artery, at or below the medial malleolus, the dorsalis pedis (DP) artery, and the pedal branches (PBs) arteries, defined as any tarsal, plantar, or anterior lateral malleolar arteries.…”

“…[1][2][3][4][5][6][7][8][9][10] Using the PA in lower extremity arterial reconstruction has always been a controversial issue, however, especially when a patent inframalleolar artery is available. [11][12][13][14] The PA is relatively spared from the terminal stages of atherosclerosis 1,15 and is often the last tibial vessel to become occluded in diabetes or end-stage vascular disease.…”

Long-term outcomes of patients undergoing endovascular infrainguinal interventions with single-vessel peroneal artery runoff

“…30 Furthermore, the long-term LS presented here is similar to the 68% to 93% LS rates for open peroneal artery bypass reported in the literature. [31][32][33] This study is a single-center, retrospective analysis and is therefore limited by the potential for referral and selection bias. Furthermore, patency was determined by return of symptoms and change in ABI/PVR due to its costeffectiveness.…”

Der Fibularisbypass – Analyse der Patientendaten der Universität Würzburg zwischen 1990 und 1994

“…These results were not significantly different from those of other crural reconstructions. Plecha et al [9] und Shortell et al [12] fanden dagegen keinen Ein fluß der radiologischen Darstellbarkcit der Kollateralen zum Ar cus plantaris auf die Bypassdurchgängigkeit. Signifikant mit der Bypassfunktion korreliert waren bei Shortell et al [12] …”