The Management of Early In Situ Saphenous Vein Bypass Occlusions

Shoenfeld, Norman A.

doi:10.1001/archsurg.1987.01400200021002

Cited by 17 publications

(14 citation statements)

References 7 publications

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“…Thrombo-embolectomy alone is unlikely to restore the circulation in an occluded vein graft. 86,87 If no anatomical explanation for graft failure can be identified, the prognosis for long term patency and limb salvage is poor. If the cause of the graft failure (e.g., anastomotic stenosis or poor runoff) is identified and addressed, more favourable outcomes have been reported.…”

Section: Classmentioning

confidence: 99%

“…ALI caused by late graft thrombosis (> 30 days) is usually the result of progression of atherosclerosis proximal or distal to the graft, atherosclerosis within the graft, fibrotic stenosis or intimal hyperplasia in the graft, or aneurysmal dilatation. 86,87 No comparative studies have specifically addressed the optimal treatment for occluded bypasses causing ALI.…”

Section: Classmentioning

confidence: 99%

See 1 more Smart Citation

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Björck

Earnshaw

Acosta

et al. 2020

European Journal of Vascular and Endovascular Surgery

319

222

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Section: Classmentioning

confidence: 99%

Section: Classmentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Björck

Earnshaw

Acosta

et al. 2020

European Journal of Vascular and Endovascular Surgery

319

222

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“…25 this should be an uncommon problem in modern vascular surgery. the most important factor in avoiding early graft failure is to recognize any technical errors during the procedure that may contribute to failure and correct them intraoperatively.…”

Section: Intraoperative Evaluationmentioning

confidence: 96%

Bypass Surgery for Lower Extremity Limb Salvage: Vein Bypass

El-Sayed

2012

Methodist DeBakey Cardiovascular Journal

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Bypass surgery for limb salvage in cases of chronic limb ischemia is a well-established treatment modality. Use of an autogenous vein provides the best conduit for infrainguinal arterial bypass procedures, particularly for bypass to the infrapopliteal arteries. In this article, we discuss infrainguinal vein bypass surgery including indications, perioperative care, and long-term follow up. We also discuss the outcomes of the procedure with regard to patient survival and limb salvage. The autogenous vein continues to be the best available conduit with the highest patency rate and the best treatment option. Compared to all other revascularization options for infrainguinal disease, the vein bypass has the best limb salvage and long-term survival in patients appropriately selected for the procedure.

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“…Bypass surgery remains a gold standard for lower limb revascularization in the case of complex anatomical changes (Global Limb Anatomic Staging System, GLASS III) based on Global Vascular Guidelines (GVG), provided the operative risk is acceptable or if endovascular treatment has failed [1,2]. Technical errors are the most important factor impacting the results of bypass surgery [3,4]. Therefore, the intraoperative use of angiography, angioscopy, and sonography can improve the results [4,5].…”

Section: Introductionmentioning

confidence: 99%

The Impact of a Simplified Hydrostatic Bypass Flow Technique on Error Detection during Surgical Limb Revascularization

Rybicka

Rynio

Samad

et al. 2020

JCM

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Technical errors have an impact on the results of surgical lower limb revascularization. Use of ultrasound scanning or angiography on the operating table is inconvenient and, in case of angiography, carries a certain risk of radiation and contrast exposure. A simpler method of screening for errors is required. This study assessed the accuracy of a new simple hydrostatic bypass flow technique during surgical limb revascularization. In all, 885 patients were included in the retrospective study. All were treated for Chronic Limb-Threatening Ischemia (CLTI) with a femoropopliteal bypass. Preoperatively, the radiological Vascular Surgery/International Society of Cardiovascular Surgery (SVS/ISCVS) score was used to assess the complexity of the anatomical changes. The surgeon made a subjective runoff assessment for every surgery. In 267 cases, the hydrostatic bypass flow (HBF) technique was used, and, in 66 cases, a digital subtraction angiography (DSA) was used. In each case, a postoperative Doppler ultrasound (DUS) examination was performed following the HBF. Good early results were achieved in 89.46%, and 154 errors (17.4%) were detected (85 were detected on the operating table, including 57 technical errors). Independent efficacy in error detection was proven with a postoperative Doppler examination (Aera Under Curve (AUC) = 0.89; criterion mid-graft peak systolic velocity (PSV) <24 cm/s, p = 0.00001) and hydrostatic bypass flow (AUC = 0.71, criterion HBF < 53 mL/min, p = 0.00001) during surgery. The hydrostatic bypass flow technique is an effective intraoperative screening method in bypass surgery. Algorithmic use of HBF, DSA if needed, and DUS postoperatively improves the outcome. HBF sufficiently reduced the need for on-table angiography.

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The Management of Early In Situ Saphenous Vein Bypass Occlusions

Cited by 17 publications

References 7 publications

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Editor's Choice – European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia

Bypass Surgery for Lower Extremity Limb Salvage: Vein Bypass

The Impact of a Simplified Hydrostatic Bypass Flow Technique on Error Detection during Surgical Limb Revascularization

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