The consequences of a failed femoropopliteal bypass grafting: Comparison of saphenous vein and PTFE grafts

Jackson, Mark R.; Belott, Todd P.; Dickason, Timothy J.; Kaiser, William J.; Modrall, J. Gregory; Valentine, R. James; Clagett, G. Patrick

doi:10.1067/mva.2000.108634

Cited by 111 publications

(64 citation statements)

References 11 publications

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“…A similar scenario was shown when ePTFE grafts were compared with saphenous vein grafts for femoral-popliteal artery bypass. Investigators 16 found a higher incidence of patients presenting with grade II acute ischemia, and deterioration of arterial runoff when ePTFE grafts thrombosed, compared with their vein counterparts. Despite the encouraging results of endovascular therapy in the short term, long-term data are lacking.…”

mentioning

confidence: 97%

Contemporary outcomes after superficial femoral artery angioplasty and stenting: The influence of TASC classification and runoff score

Ihnat

Duong

Taylor

et al. 2008

Journal of Vascular Surgery

135

101

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Self-expanding stents produce acceptable outcomes for treatment of SFA disease. Poorer patency rates are associated with TASC D lesions and poor initial runoff score; HTN was associated with improved patency rates. Stent occlusion and in-stent stenosis were not entirely benign; one-third of patients had deterioration of their tibial artery runoff. Future studies of SFA interventions need to stratify TASC classification and runoff score. Further evaluation of the long-term effects of SFA stenting on tibial runoff is needed.

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mentioning

confidence: 97%

Contemporary outcomes after superficial femoral artery angioplasty and stenting: The influence of TASC classification and runoff score

Ihnat

Duong

Taylor

et al. 2008

Journal of Vascular Surgery

135

101

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“…Apart from just patency rates, there has been little emphasis on the ischemic consequences of occlusion of a vein or PTFE bypass graft. It has been shown, though, that patients with occluded PTFE femoropopliteal reconstructions are at greater risk of limb-threatening ischemic complications and more frequently required emergency redosurgery than patients with vein-graft reconstructions [31]. Among several possible factors that might account for this, intermittent micro-thromboembolism from prosthetic grafts may lead to compromise of the tibial run-off.…”

Section: Type Of Graft and Patency Ratesmentioning

confidence: 94%

The role of vein grafts in peripheral vascular disease and carotid artery disease

Walter

Magometschnigg

2007

Eur Surg

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Die Rolle von autologen Venegrafts in derChirurgie der peripheren Verschlußkrankheit und der Karotisstenose Zusammenfassung. Grundlagen: Die periphere Bypasschirurgie hat sich zu einer weit verbreiteten und erfolgreichen Behandlungsform fü r Patienten mit peripherer arterieller Verschlußkrankheit entwickelt.Methodik: Review der Fachliteratur. Ergebnisse: Obwohl Kunststoffprothesen als BypassGrafts stä ndig weiterentwickelt und verbessert werden, sind Venenbypass-Grafts nach wie vor unü bertroffen in Bezug auf ihre Sicherheit und Offenheitsraten. Um einen Langzeiterfolg fü r den Patienten zu gewä hrleisten, sind regelmä ßige Kontrollen und begleitende medikamentö se Therapie wichtig.Die Carotis-Thrombendarterektomie ist eine gut untersuchte und hä ufig durchgefü hrte Operation zur Reduzierung des Schlaganfallrisikos bei Carotisstenosen. Nach wie vor herrscht Diskussion ü ber das optimale Patchmaterial fü r den Verschluß der Arteriotomie. Aktuelle Meta-Analysen scheinen jedoch zu belegen, daß lediglich sehr kleine, wenn ü berhaupt, Unterschiede zwischen Venen-und Kunststoffpatches bestehen.Schlussfolgerungen: Trotz Verbesserungen der synthetischen Gefä ßersatz-Materialien sind autologe Venengrafts nach wie vor in der modernen Gefä ßchirurgie unverzichtbar.

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“…Bypasses to the suprageniculate popliteal artery segments can be performed with prosthetic grafts. However, despite a lack of significant differences in graft patency and limb salvage between autologous and prosthetic conduits in an above-knee configuration, controversy remains as to long-term performance and thromboembolic complications associated with prosthetic graft failure [25,26]. In addition, prosthetic bypasses should be avoided in patients with foot sepsis or active infection, in order to avoid arterial graft infection.…”

Section: Relative Roles Of Surgery and Endovascular Interventionmentioning

confidence: 98%

Critical limb ischemia

Dawson

Hagino

2001

Curr Treat Options Cardio Med

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Patients with critical limb ischemia (CLI) present with ischemic rest pain or with tissue loss. Tissue loss, in its mildest presentation, includes focal ischemic ulceration or nonhealing wounds. Gangrene is the manifestation of severe chronic ischemia. Without revascularization, patients with CLI are at risk for limb loss and for potentially fatal complications from the progression of gangrene and the development of sepsis. The best patient outcomes are achieved when the diagnosis and appropriate treatment for CLI are not delayed. Simple noninvasive tests, such as measurement of ankle-to-brachial indices or toe Doppler pressures, take only minutes to provide sufficient information to confirm the diagnosis of peripheral artery disease (PAD) and to document the severity of limb ischemia. Subsequent diagnostic imaging studies, such as arteriography, magnetic resonance angiography, or ultrasound duplex scanning, provide the detailed information needed to plan revascularization therapy. Balloon angioplasty and stenting work best for focal segments of narrowing or short occlusions of the iliac arteries, but endovascular treatments yield progressively poorer results with longer and more distal lesions. Long segments of occlusion, especially those distal to the common femoral artery, are best treated with surgical bypass. Pharmacotherapy and adjunctive therapies, such as topical therapies or hyperbaric oxygen treatment, may have a limited role in patients in whom revascularization procedures have failed or for those in whom revascularization is not technically possible--particularly when amputation is the only alternative. Prostanoids are the best-studied class of drugs for such applications, but their use is still investigational in the United States. Though other medical approaches, such as use of other vasoactive agents, drugs that treat claudication, or gene-induced angiogenesis may prove useful, they do not yet have demonstrated roles in the treatment of patients with CLI.

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The consequences of a failed femoropopliteal bypass grafting: Comparison of saphenous vein and PTFE grafts

Cited by 111 publications

References 11 publications

Contemporary outcomes after superficial femoral artery angioplasty and stenting: The influence of TASC classification and runoff score

Contemporary outcomes after superficial femoral artery angioplasty and stenting: The influence of TASC classification and runoff score

The role of vein grafts in peripheral vascular disease and carotid artery disease

Critical limb ischemia

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