Results of Obturator Foramen Bypass in Patients with Groin Infection and Arterial Involvement

Dunphy, Kaitlyn M.; Hassey, Joseph; Vallabhaneni, Raghuveer; Alfawaz, Abdullah; Kiguchi, Misaki M.; Fatima, Javairiah; Woo, Edward Y.; Abramowitz, Steven D.

doi:10.1016/j.avsg.2021.02.011

Cited by 2 publications

(3 citation statements)

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“…Therefore, infected groin problems that often involve foreign prosthetic material or remnants of percutaneous femoral closure devices might be challenging and require control of bleeding, removal of foreign material, wide debridement, and sometimes arterial resection. Management of the consequential limb ischemia in such cases is controversial, and an obturator foramen bypass is a classical approach for the treatment of contemporary groin infection, thus requiring perfect knowledge of the OA course [15].…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of the Variants of the Obturatory Artery

Brachini

Matteucci

Sapienza

et al. 2023

JCM

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Background: Knowledge of vascular anatomy and its possible variations is essential for performing embolization or revascularization procedures and complex surgery in the pelvis. The obturator artery (OA) is a branch of the anterior division of the internal iliac artery (IIA), and it has the highest frequency of variation among branches of the internal iliac artery. Possible anomalies of the origin of the obturator artery (OA) should be known when performing pelvic and groin surgery, where its control or ligation may be required. The purpose of this systematic review and meta-analysis, based on Sanudo’s classification, is to analyze the origin of the obturator artery (OA) and its variants. Methods: Thirteen articles published between 1952 and 2020 were included. Results: The obturator artery (OA) was present in almost all cases (99.8%): the pooled prevalence estimate for the origin from the IIA axis was 77.7% (95% CI 71.8–83.1%) vs. 22.3% (95% CI 16.9–28.2%) for the origin from EIA axis. In most cases, the obturator artery (OA) originated from the anterior division trunk of the internal iliac artery (IIA) (61.6%). Conclusions: Performing preoperative radiological examination to determine the pelvic vascular pattern and having the awareness to evaluate possible changes in the obturator artery can reduce the risk of iatrogenic injury and complications.

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Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of the Variants of the Obturatory Artery

Brachini

Matteucci

Sapienza

et al. 2023

JCM

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“…This procedure's justification is to prevent polluted, infected, or damaged tissues in the groin by constructing an arterial conduit from the aortoiliac section to the superficial femoral, popliteal, or deep femoral artery, depending on run-off circumstances ( 8 ).The femoral triangle is avoided by directing the vascular graft via the obturator foramen, dorsally to the hip joint, in a layer between the adductor magnus and longus muscles. It has been shown that autologous saphenous vein provides satisfactory outcomes and lowers the risk of subsequent graft infection ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

“…The femoral triangle is avoided by directing the vascular graft via the obturator foramen, dorsally to the hip joint, in a layer between the adductor magnus and longus muscles. It has been shown that autologous saphenous vein provides satisfactory outcomes and lowers the risk of subsequent graft infection (9).…”

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confidence: 99%

Extra-anatomical Obturator Bypass Due to Groin Infection

Moawed

Abd-Elghany

2023

MJIRI

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Background A rather common side effect of using prosthetic grafts is infection of the groin area. Infections in the groin may be avoided by performing arterial bypass tenneling via the obturator foramen during lower extremity revascularization. This study aimed to evaluate the safety and efficacy of extra-anatomical bypass obturator in patients with groin infection. Methods This cohort included a convenient sample of 100 patients with groin infections who planned to do an extra-anatomical obturator bypass. All patients were subjected to history taking and clinical assessment. Ultrasonography with duplex screening is a good initial technique to assess groin masses. Combination of computed tomography (CT) or magnetic resonance imaging (MRI) with indium-labeled leucocyte scintigraphy can also play a role in the diagnosis. Results Inflow from the already-existing graft limb was used in 54% of obturator canal bypass (OCB) procedures, with 32 limbs coming from the main iliac (27.3%) and 6 limbs from the infrarenal aorta (5.1%). The distal superficial femoral artery was used in 21 limbs (17.9%), while the above-knee popliteal artery was selected as the outflow artery in 82% of cases. Primary aided patency was 68% at 24 months, according to Kaplan-Meier analysis, whereas primary patency was 63% at that time. At 24 months, the secondary patency of the OCB was 83%. Conclusion In case of groin infections, an excellent option to restore flow is an obturator bypass graft. This graft is strong, reliable, and safe. As a result of its high patency rate, it may be the first choice in certain circumstances.

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Results of Obturator Foramen Bypass in Patients with Groin Infection and Arterial Involvement

Cited by 2 publications

References 10 publications

Systematic Review and Meta-Analysis of the Variants of the Obturatory Artery

Systematic Review and Meta-Analysis of the Variants of the Obturatory Artery

Extra-anatomical Obturator Bypass Due to Groin Infection

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