Ann Surg Treat Res.  2014 Feb;86(2):91-94. 10.4174/astr.2014.86.2.91.

Long-term outcome of crossover femoro-femoro-popliteal bypass using side-to-side anastomosis in ilio-femoral occlusive disease

• Kim YS
• Yun WS
• Park K

• KMID: 1908503
• DOI: http://doi.org/10.4174/astr.2014.86.2.91

Abstract

PURPOSE
During crossover femoro-femoro-popliteal sequential bypass (CFFPB) surgery in ilio-femoral occlusive disease, proximal anastomosis of the femoro-popliteal bypass is usually performed distal to the distal anastomosis of the crossover femoro-femoral bypass. If not, it is done with a piggyback configuration. Another method is a side-to-side anastomosis. Its benefit is that this is the only anastomosis made. And it is less bulky compared with the piggyback configuration. This study was aimed to investigate the long-term outcome of CFFPB using side-to-side anastomosis.
METHODS
From Sep 2006 to Aug 2012, 21 patients who underwent CFFPB using side-to-side anastomosis were enrolled. Externally supported polytetrafluoroethylene graft was used as a conduit in all patients. Patient demographic data and procedure details were investigated. Primary graft patency was calculated using the Kaplan-Meier method.
RESULTS
The mean age of patients was 79 years (range, 62-81 years) and males were 17 (81%). Fifteen patients (71%) had critical limb ischemia. Inflow arteries comprised of 16 common femoral artery (CFA), 4 superficial femoral artery (SFA), and 1 deep femoral artery (DFA). Side-to-side anastomosis was performed on the CFA in 11, SFA in 2, and DFA in 8 patients. During the mean follow-up period of 21 months (1-60 months), 8 patients died. The 1-, 3-, and 5-year primary patency rates were 76%, 63%, and 63%.
CONCLUSION
Long-term patency of CFFPB using side-to-side anastomosis was acceptable. It can be one of the treatment options for patients with ilio-femoral occlusive disease.

Keyword

Bypass surgery; Anastomosis

MeSH Terms

Arteries
Extremities
Femoral Artery
Follow-Up Studies
Humans
Ischemia
Male
Polytetrafluoroethylene
Transplants
Polytetrafluoroethylene

Figure

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  Fig. 1 Anastomosis configurations on recipient femoral artery during femoro-femoro-popliteal sequential bypass. (A) Two separate anastomoses, (B) piggyback configuration, (C, D) side-to-side anastomosis.

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  Fig. 2 Kaplan-Meier curve of cumulative primary patency.

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