Thoracic Aortobifemoral Bypass in Treatment of Juxtarenal Leriche Syndrome (Midterm Results)

Köksal, Cengiz; Kocamaz, Özgür; Aksoy, Eray; Çakalağaoğlu, Cantürk; Kara, İbrahim; Yanartaş, Mehmed; Ay, Yasin

doi:10.1016/j.avsg.2012.04.005

Cited by 10 publications

(6 citation statements)

References 24 publications

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“…With respect to longer term outcomes, the largest published series to date by Passman et al 16 reported a 5-year primary patency of 79% in 50 patients 16 . Koksal et al 12 reported a series of 20 patients undergoing TFB also via a thoracotomy with 5-year patency rate of 94% similar to our study.…”

Section: Discussionsupporting

confidence: 90%

“…Few contemporary reports of TFB outcomes exist 12,13 and most commonly, historical series highlight use of a left anterolateral thoracotomy with a descending thoracic aortic end-toside anastomosis and blind retroperitoneal tunneling through the diaphragm [14][15][16][17][18] . This approach may lead to pulmonary, diaphragmatic and/or tunnel related complications.…”

Section: Introductionmentioning

confidence: 99%

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Contemporary outcomes of thoracofemoral bypass

Crawford

Scali

Giles

et al. 2019

Journal of Vascular Surgery

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Objectives: Thoracofemoral bypass (TFB) is an alternative to aorto-femoral (AFB) or extraanatomic bypass for severe aorto-iliac occlusive disease (AIOD). TFB may be particularly useful in select patients with concurrent visceral aortic branch vessel disease, infrarenal aortic occlusions or after failed AFB. However, there are few contemporary series describing the indications and outcomes for TFB. Therefore, the purpose of this analysis was to review our experience with TFB. Methods: All patients undergoing TFB for occlusive disease from 2002-2017 were reviewed. All subjects underwent left thoraco-retroperitoneal exposure of the supra-celiac aorta with division of the diaphragmatic crus and supra-celiac cross-clamping. An end-to-side aortic anastomosis was created and each graft limb was tunneled in the retroperitoneum to the femoral bifurcation. Adjunctive visceral/infra-inguinal revascularization was selectively performed based on symptoms, end-organ function and/or preoperative imaging. The primary end-points were major complications and 30-day mortality. Secondary end-points included limb patency, freedom from major adverse limb events (MALE), and survival. Kaplan-Meier methodology was used to characterize end-points. Results: Forty-one patients [age: 61±9 years; female-54%, hypercoaguable state-7%] underwent TFB. Mean preoperative ankle brachial index (ABI) was 0.4, bilaterally. Indications included: critical limb ischemia (56%), claudication (30%), acute limb ischemia (7%) and combined AIOD +mesenteric ischemia (7%). Seven (17%) had previously undergone AFB and 15(38%) underwent any prior aortic operation. Adjunctive visceral bypass occurred in 8(20%) (14 grafts: renal-6, superior mesenteric artery-5, celiac-3). Postoperative LOS was 11 [IQR 7, 16] days and 30-day mortality was 5% (n=2). Major complications occurred in 34% (n=14; pulmonary-15%, cardiac-12%, bleeding-7% [accidental splenectomy-5%], renal-5%, wound-2%). Mean postoperative ABI was 0.9, bilaterally.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Contemporary outcomes of thoracofemoral bypass

Crawford

Scali

Giles

et al. 2019

Journal of Vascular Surgery

View full text Add to dashboard Cite

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“…Although performed infrequently in the modern era of vascular intervention, the operation remains effective, with recent studies showing one-year primary patency over 85% and one-year survival over 90%. [24][25][26] Herein is reported the use of this historic procedure for aortic occlusion as a complication of RPF. Given severe pathology and complex occlusion demonstrated on imaging, endovascular reconstruction was not considered.…”

Section: Discussionmentioning

confidence: 99%

Thoracobifemoral bypass for infrarenal aortic occlusion caused by retroperitoneal fibrosis

Wang

Khoury

Joob

et al. 2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Since its first description by Blaisdell et al, 1 various thoracic aorta‐bifemoral bypass techniques have been described 2–4 . These techniques provide a safe approach with good outcomes for treating juxtarenal aortic occlusions, preventing laparotomy‐related complications, and using the less atherosclerotic thoracic aorta as an inflow source 5 . Concomitant coronary artery bypass graft (CABG) and ascending aorta to femoral artery bypass surgery have been advised for unstable patients with critical coronary stenosis requiring emergency revascularization in the lower extremities 6 .…”

Section: Introductionmentioning

confidence: 99%

“…the less atherosclerotic thoracic aorta as an inflow source. 5 Concomitant coronary artery bypass graft (CABG) and ascending aorta to femoral artery bypass surgery have been advised for unstable patients with critical coronary stenosis requiring emergency revascularization in the lower extremities. 6 Additionally, the use of the left internal thoracic artery (LITA) in young patients with Leriche syndrome has been described as an indication for single-stage coronary and peripheral revascularization.…”

mentioning

confidence: 99%

On‐pump coronary artery bypass with concomitant descending thoracic aorta‐bi‐iliac bypass: A case report

et al. 2021

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The presence of critical coronary artery disease and concomitant critical limb ischemia represents a clinical challenge. Single‐stage operations for cardiac and peripheral revascularization can be an option in such cases. The “Süzer technique” provides a more physiological extra‐anatomical vascular reconstruction by using the descending thoracic aorta as the inflow source. This is an alternative to the more widely used technique of ascending aorta to bifemoral bypass and concomitant coronary revascularization. We report a case of critical limb ischemia with juxtrarenal aortic occlusion and left main coronary artery stenosis treated with concomitant coronary artery bypass grafting and descending thoracic aorto‐bi‐iliac bypass using a modification of the Süzer technique.

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Thoracic Aortobifemoral Bypass in Treatment of Juxtarenal Leriche Syndrome (Midterm Results)

Cited by 10 publications

References 24 publications

Contemporary outcomes of thoracofemoral bypass

Contemporary outcomes of thoracofemoral bypass

Thoracobifemoral bypass for infrarenal aortic occlusion caused by retroperitoneal fibrosis

On‐pump coronary artery bypass with concomitant descending thoracic aorta‐bi‐iliac bypass: A case report

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