Korean J Thorac Cardiovasc Surg.
2017 Oct;50(5):371-377. 10.5090/kjtcs.2017.50.5.371.
Femoro-Supragenicular Popliteal Bypass with a Bridging Stent Graft in a Diffusely Diseased Distal Target Popliteal Artery: Alternative to Below-Knee Popliteal Polytetrafluoroethylene Bypass
- Affiliations
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- 1Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Korea.
- 2Department of Radiation Oncology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Korea.
- 3Department of Radiology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Korea. yawoo114@naver.com
- KMID: 2398393
- DOI: http://doi.org/10.5090/kjtcs.2017.50.5.371
Abstract
- BACKGROUND
Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease.
METHODS
Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral-above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications.
RESULTS
All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks.
CONCLUSION
In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
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