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
  • 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

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.

Keyword

Arteries; Bypass; Graft; Stents
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