Surgical Fenestration for Lower Limb Ischemia Developing from Chronic Type B Aortic Dissection: A Report of 2 Cases

Ikeda, Akihiko; Kudo, Yohei; Konishi, Takako; Matsuzaki, Kanji; Jikuya, Tomoaki

doi:10.1016/j.avsg.2015.08.029

Cited by 2 publications

(1 citation statement)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…And it will certainly prolong the ischemic time of the lower limbs. Therefore, some authors advocate staged approach with initial percutaneous or surgical intervention, to restore the perfusion of the ischemic leg as soon as possible, when the ischemic time is closed to 6 h or even more [6][7][8][9]. But this will delay the aortic repair, with a continuously increase risk of the aortic rupture [10], which was reported to be approximately 1% per hour in the first 24 h [11].…”

Section: Introductionmentioning

confidence: 99%

A modified axillo-femoral perfusion for acute type a aortic dissection accompanied with lower limb malperfusion

Shen

et al. 2020

J Cardiothorac Surg

View full text Add to dashboard Cite

Background: Lower limb malperfusion accompanied with acute type A dissection (AAD) is reported to be an independent predictor for mortality. Timely treatment is required. However, staged approach to restore the perfusion of the ischemic leg before aortic repair has a continuously increase risk of aortic rupture. Aortic repair under isolated axillary artery perfusion also has the risk of prolonging leg ischemia. Here we introduce our experience in performing axillo-femoral perfusion, which is supposed to bring benefits for treating lower limb malperfuison. Methods: Thirty patients who suffered AAD accompanied by lower limb ischemia enrolled in our study. All patients received aortic repair as soon as possible using the modified axillo-femoral perfusion approach. The cardiopulmonary bypass and cooling started with the right axillary artery perfusion. Then the femoral artery of the ischemic side was exposed and sewn to a graft connected with another inflow cannula. The rectal temperature was about 31°C when the femoral perfusion started. The perfusion of the ischemic legs preoperative was estimated after the surgery by the clinical signs, the saturation of the distal-limb, and computed tomography scan. Results: Twenty-eight patients got good perfusion of the lower body after the surgery. Two patients received femoralfemoral artery bypass immediately after surgery because of the thrombosis in the right common iliac artery, without further injury. No peripheral vessels damage occurred, and no compartment fasciotomy or amputation needed. One patient died for the sepsis and the subsequent multi organ failure 28 days postoperative. Conclusions: The modified axllio-femoral perfusion could restore the lower limbs' perfusion simultaneously during the aortic surgery without neither delaying dissection repair nor prolonging the ischemic time. It is a simple, but safe and effective technique.

show abstract

Section: Introductionmentioning

confidence: 99%

A modified axillo-femoral perfusion for acute type a aortic dissection accompanied with lower limb malperfusion

Shen

et al. 2020

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

Endovascular branch fenestration and/or stenting may be a viable treatment option for lower limb malperfusion due to acute type B aortic dissection

Henry¹

2020

Clin. Res. Pract.

View full text Add to dashboard Cite

show abstract

Surgical Fenestration for Lower Limb Ischemia Developing from Chronic Type B Aortic Dissection: A Report of 2 Cases

Cited by 2 publications

References 18 publications

A modified axillo-femoral perfusion for acute type a aortic dissection accompanied with lower limb malperfusion

A modified axillo-femoral perfusion for acute type a aortic dissection accompanied with lower limb malperfusion

Endovascular branch fenestration and/or stenting may be a viable treatment option for lower limb malperfusion due to acute type B aortic dissection

Contact Info

Product

Resources

About