scholarly journals Primary Patency of Infrainguinal Bypass is Correlated to the Quality of the Profunda Femoral Artery

2021 ◽  
Vol 74 (4) ◽  
pp. e391
Author(s):  
Alexis Peters ◽  
Ankita Nallani ◽  
Raja K. Rajamanickam ◽  
Todd R. Vogel ◽  
Jonathan Bath ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Primary Patency ◽  
Infrainguinal Bypass

Omniflow II biosynthetic grafts versus expanded polytetrafluoroethylene grafts for infrainguinal bypass surgery. A single-center retrospective analysis

Vascular ◽  
2021 ◽  
pp. 170853812110298
Author(s):  
Bart CT van de Laar ◽  
Hugo C van Heusden ◽  
Pieternel CM Pasker-de Jong ◽  
Vincent van Weel
Keyword(s):  
Limb Salvage ◽  
Infection Rate ◽  
Bypass Surgery ◽  
Primary Patency ◽  
Knee Surgery ◽  
Secondary Patency ◽  
Single Center ◽  
Expanded Polytetrafluoroethylene ◽  
Infrainguinal Bypass ◽  
Omniflow Ii

Introduction: The aim of this study is to evaluate the outcome of Omniflow II biosynthetic vascular grafts as compared to synthetic expanded polytetrafluoroethylene (ePTFE) grafts in infrainguinal bypass surgery. Methods: A single-center, retrospective, observational study was performed reviewing patients with critical limb ischemia who underwent infrainguinal bypass surgery between 2014 and 2018. Patients characteristics, graft characteristics, and treatment outcomes were collected. Patency rates were compared using Kaplan–Meier estimates. Results: Sixty bypasses were performed in 57 patients. For above-knee surgery, six were Omniflow and 13 were synthetic. For below-knee surgery, 19 were Omniflow and 22 were synthetic. Patient characteristics between groups were similar. However, American Society of Anesthesiologists (ASA) classification scores were higher in the Omniflow group as compared to ePTFE (88% was ASA 3 or higher versus 60%; p = 0.018). Furthermore, wound, ischemia, and foot infection (WIfI) composite scores were higher in the Omniflow group ( p = 0.0001). There was a trend toward more active infection at time of surgery in the Omniflow group (40 vs 22.9%, p = 0.15). At 1 year, primary patency rates were 60.0% versus 46.9% for above-knee Omniflow versus ePTFE grafts, respectively ( p = 0.72). Secondary patency rates were 80.0% versus 82.5% ( p = 0.89), and limb salvage rates were 83.3% versus 100% ( p = 0.14). For below-knee surgery, 1- and 2-year primary patency rates in Omniflow versus ePTFE grafts were 36.0% versus 41.8% ( p = 0.60) and 36.0% versus 31.1% ( p = 0.87). Secondary patency rates were 66.8% versus 75.2% at 1 year ( p = 0.53) and 58.8% versus 48.3% ( p = 0.77) at 2 years. Below-knee limb salvage rates for Omniflow versus ePTFE after 2 years were 88.0% versus 68.3% ( p = 0.28), respectively. Aneurysmal degeneration occurred in 2/25 (8%) in the Omniflow group and 0/35 (0%) in the ePTFE group. Bypass infections occurred in 2/25 (8%) in the Omniflow group and 0/35 (0%) in the ePTFE group ( p = 0.09). Conclusion: Omniflow bypasses were more commonly implanted in patients with higher limb infection rate as confirmed with a higher adapted WIfI score. A trend toward a higher infection rate of Omniflow grafts was observed but not statistically significant. Graft infection rates were relatively low and treatable with antibiotics. No significant difference in graft performance was observed. The choice between the two studied grafts remains based on surgeon’s preference.

scholarly journals Basilic Vein Transposition Used as a Tertiary Vascular Access for Hemodialysis: 15 Years of Experience

2016 ◽  
Vol 8 ◽  
pp. OJCS.S34837 ◽  
Author(s):  
Róbert Novotný ◽  
Marcela Slavíková ◽  
Jaroslav Hlubocký ◽  
Petr Mitáš ◽  
Jan Hrubý ◽  
...  
Keyword(s):  
Vascular Access ◽  
Infectious Complications ◽  
Primary Patency ◽  
Secondary Patency ◽  
Basilic Vein ◽  
Time Period ◽  
Patient Database ◽  
Arteriovenous Access

Introduction The quality of the life in patients requiring long term hemodialysis is directly proportional to the long-term patency of their vascular access. Basilic vein transposition for vascular access (BAVA) represents a suitable option for creating a tertiary native vascular access for hemodialysis on the upper extremities for patients requiring long term hemodialysis. The purpose of the study is to compare BAVAs with arteriovenous grafts (AVG). Method Data collection was based on selecting all of the patients with BAVA created in the time period in between January 1996 and August 2011. A questionnaire was created and sent to the selected hemodialysis centers. The resulting set of data was statistically analyzed and evaluated. Results In the time period between 1 January 1996 and August 2011, arteriovenous access for hemodialysis was created in 6754 patients (7203 procedures in total). Out of these patients, 175 BAVAs were created. Our patient database of those undergoing the BAVA procedure consisted of 98 females (56%) and 77 males (44%) with an average age of 64.5 years. The prevalence of diabetes mellitus was 60% (105 patients). Primary patency after 12 months was 68.8%, 24 months 59.7%, 36 months 53.8, 48 months 53.8%, and 60 months 50%. Primary assisted patency after 12 months was 89.9%, 24 months 84.6%, 36 months 77.8%, 48 months 77.9%, 60 months 70.8%. Secondary patency after 12 months was 89.4%, 24 months 86.9%, 36 months 81%, 48 months 78.9%, 60 months 75.7%. Twenty-nine BAVAs (16.5%) were obliterated. Conclusion Patients benefit from this type of procedure due to the longer patency of a native arteriovenous access, as well as a lower incidence of infectious complications.

Quality of Life after Balloon Angioplasty versus Stent Implantation in the Superficial Femoral Artery: Findings from a Randomized Controlled Trial

2007 ◽  
Vol 14 (4) ◽  
pp. 431-437 ◽  
Author(s):  
Schila Sabeti ◽  
Alfa Czerwenka-Wenkstetten ◽  
Petra Dick ◽  
Oliver Schlager ◽  
Jasmin Amighi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Femoral Artery ◽  
Balloon Angioplasty ◽  
Superficial Femoral Artery ◽  
Stent Implantation ◽  
Controlled Trial ◽  
Limb Ischemia ◽  
Post Intervention ◽  
Primary Stenting

Purpose: To investigate whether primary nitinol stenting in the superficial femoral artery (SFA) is beneficial to patients' quality of life (QoL). Methods: One hundred four patients (55 men; mean age 66±19 years) with chronic limb ischemia and SFA disease were randomly assigned to primary stent implantation (n=51) or balloon angioplasty (n=53) with optional stenting for a suboptimal angioplasty result (17 of 53). QoL was measured by the SF-36 questionnaire at baseline and at 3, 6, and 12 months post intervention. Results: QoL was significantly improved post intervention and up to 12 months in both treatment groups. Significant inverse associations were observed between QoL parameters and restenosis. Comparing primary stenting (n=51) versus balloon angioplasty with optional stenting (n=53) by the intention to treat, no significant differences in QoL were observed. Analyses of stented patients (n=68) versus balloon angioplasty (n=36) patients, however, demonstrated significantly improved measures of QoL after stenting. Conclusion: Endovascular revascularization of SFA disease improves QoL, and restenosis negatively affects QoL outcomes. After stent implantation, whether primary or secondary, QoL was significantly ameliorated compared to balloon angioplasty alone. However, it remains to be proven in larger cohorts whether primary stenting yields a QoL benefit compared to balloon angioplasty with optional secondary stenting.

scholarly journals The deep femoral artery as a inflow source for distal reconstruction

2019 ◽  
Vol 41 part 2 (2) ◽  
pp. 35-38
Author(s):  
V. I. Rusyn ◽  
V. V. Korsak ◽  
V. V. Rusyn ◽  
F. V. Horlenco ◽  
V. M. Dobosh
Keyword(s):  
Quality Of Life ◽  
Femoral Artery ◽  
Limb Ischemia ◽  
Deep Femoral Artery ◽  
Autologous Vein ◽  
Vein Bypass ◽  
Profunda Femoris ◽  
Chronic Limb Ischemia

of the study. To improve the treatment outcomes of patients with occlusion-stenotic lesions of the femoral-popliteal-tibial segment, long-term results of the profundafemorispopliteal autologous vein bypass surgery have been studied. Material and methods. In the surgical clinic of A. Novak Regional Clinical Hospital during the last 10 years has been performed 300 isolated profundoplasty at chronic limb ischemia. In 16 p atients w ith d eep femoral popliteal autologous vein bypass, a distal segment of arteria profunda femoris was used as the «tidal» artery, which varied from 0,51 to 0,63 in diameter (0,58 cm in average). Results. In the immediate and long-term follow-up period, no thrombosis of profunda femoris popliteal autologous vein shunt was observed in 5 years. The ankle-brachial pressure index after surgery increases almost twice and approaches 0,9 on posterior tabial artery. The mean profunda popliteal collateral index score decreased to 0,301 ± 0,099 in all patients after surgery. If we compare the quality of life after profunda femoris popliteal autologous vein reconstruction, it should be noted that the quality of life in our patients before the operation was 21,8 ± 4,9 points, after the operation − 45,6 ± 4,9 points. Conclusion.Profundafemorispopliteal autologous vein bypass by a length of up to 15 cm provides blood supply to the limb with stenoticocclusive lesions of the femoral-popliteal-tibial segment, with the passage of at least one artery of the leg and the arteries of the pedis. Keywords: chronic limb ischemia; deep femoral artery, prufundoplasty.

scholarly journals Causes of origin and diagnosis of postpunctural false aneurisms of femoral arteries

2018 ◽  
Vol 85 (6) ◽  
pp. 36-39
Author(s):  
V. І. Lyakhovskyi ◽  
А. V. Sydorenko ◽  
R. P. Sakevych ◽  
О. М. Bezkorovaynyу ◽  
R. М. Rіabushko ◽  
...  
Keyword(s):  
Open Access ◽  
Femoral Artery ◽  
Precise Localization ◽  
Puncture Site ◽  
Treatment Interventions ◽  
Average Characteristic ◽  
Femoral Arteries ◽  
Endovascular Interventions ◽  
Group I

Objective. To estimate the causes of occurrence and quality of diagnosis of false aneurisms (FA) of femoral arteries after endovascular interventions. Маterials and methods. In Poltava Regional Clinical Hospital named after М. V. Sklifosovskyi in 2008 - 2017 yrs in 7237 patients 10 783 punctures of femoral arteries were performed for conduction of the diagnosis and treatment interventions in cardiological patients (Group I) and in patients, suffering occlusion-stenotic diseases of main arteries of the lower extremities (Group II). In 57 (0.79%) patients the FA of femoral arteries were revealed. All the patients were examined, using ultrasonographic color angioscanning (USCAS). Встановлені причини виникнення ХА та особливості їх діагностики. Results. FA of femoral artery was revealed on the (2.65 ± 2.31) day after the introducer extraction at average. Characteristic complaints had 45 (78.9%) patients. Using USCAS there were revealed the puncture site, the aneurism form, its spread and volume. Local and general factors, promoting development of postpunctural FA, were revealed. Conclusion. For the FA development prophylaxis it is mandatory to perform a femoral artery puncture under the USCAS control with a precise localization of the puncture performance site. In the patients with pronounced signs of hypertonic disease and obesity after conduction of a thrombolytic therapy it is expedient to use widely the apparatus for the hemorrhage arrest of the Angio Seal type under ultrasonographic control. On the first day after the introducer extraction it is obligatory to conduct a control USCAS procedure of a puncture site. In a case of diagnosis of transmural wounding of the artery and the aneurism formation the open-access urgent operative intervention must be performed.

scholarly journals Long-term outcome of common femoral artery endarterectomy in octogenarians and non-octogenarians

2020 ◽  
pp. 145749692090773
Author(s):  
C. Uhl ◽  
H. Götzke ◽  
F. Zeman ◽  
S. Woronowicz ◽  
T. Betz ◽  
...  
Keyword(s):  
Overall Survival ◽  
Femoral Artery ◽  
Common Femoral Artery ◽  
Major Amputation ◽  
Primary Patency ◽  
Versus Group ◽  
Time Period ◽  
Group 2 ◽  
Group 1

Objective: Arteriosclerotic disease of the common femoral artery can be treated by surgical or endovascular intervention. Elderly patients are said to have a worse outcome if treated by surgical means; however, data to support this theory are missing. Methods: Retrospective analysis of all patients who underwent common femoral artery endarterectomy between March 2007 and July 2018 in our clinic. Group 1 included all patients <80 years and Group 2 included all patients ⩾80 years. Endpoints were patency rates, limb salvage, and overall survival. Results: During this time period, 977 common femoral artery endarterectomies were performed. Indication was claudication in 61.5% and critical limb ischemia in 38.5%. Group 1 included 805 cases (82.4%) and Group 2 included 172 cases (17.6%). Thirty-day mortality was 2.7% (Group 1 = 1.6% versus Group 2 = 7.6%; p < 0.001) and 30-day major amputation was 1.1% (Group 1 = 0.7% versus Group 2 = 2.9%; p = .043). Primary patency and secondary patency were 84.2% and 96.8%, respectively, after 7 years. Limb salvage (93.7%, Group 1 = 94.1% versus Group 2 = 91.8%; p = .088) and overall survival (52.0%, Group 1 = 59.1% versus Group 2 = 15.7%; p = .006) were significantly different after the same time period. Multivariable analysis showed female gender to be a risk factor for loss of primary patency. Age ⩾ 80 years and ulcer or gangrene were risk factors for death. Statin use was beneficial to survival. Conclusion: Common femoral artery endarterectomy is a safe procedure with excellent long-term results. Octogenarians have an increased risk for perioperative mortality and major amputation.

scholarly journals Hybrid Endarterectomy and Endovascular Therapy in Multilevel Lower Extremity Arterial Disease Involving the Femoral Artery Bifurcation

2012 ◽  
Vol 97 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Junjie Zou ◽  
Yongxiang Xia ◽  
Hongyu Yang ◽  
Hao Ma ◽  
Xiwei Zhang
Keyword(s):  
Lower Extremity ◽  
Femoral Artery ◽  
Ankle Brachial Index ◽  
Common Femoral Artery ◽  
Arterial Disease ◽  
Primary Patency ◽  
Secondary Patency ◽  
Hybrid Procedures ◽  
Lower Extremity Arterial Disease ◽  
Group 3

Abstract The objective of this study was to evaluate the feasibility and efficacy of hybrid therapy (combined endarterectomy-endovascular) in patients with complex peripheral multifocal steno-obstructive vascular disease involving the femoral artery bifurcation. Forty-one combined procedures were performed on 40 patients. Although the common femoral artery was usually treated with endarterectomy, endoluminal procedures were performed proximally in 12 patients (group 1), distally in 18 patients (group 2), and both upward and downward in 11 patients (group 3). Patients underwent clinical assessment and ankle-brachial index measurement thereafter. Primary, assisted-primary, and secondary patency rates at 24 months were 59%, 66%, and 72%, respectively. Primary patency rates were lower in group 3 compared with groups 1 and 2 (P  =  0.015). The limb salvage rate was 86.4% at the end of the follow-up period. Hybrid procedures provide feasible and effective treatment management of selected patients with multilevel lower extremity arterial disease involving the femoral artery bifurcation.

Radial Access for Neurointervention

2021 ◽  
Keyword(s):  
Femoral Artery ◽  
Lower Risk ◽  
Vascular Complications ◽  
Artery Occlusion ◽  
Arterial Access ◽  
Transradial Access ◽  
Pseudo Aneurysm ◽  
Neurointerventional Procedures ◽  
Device Technology

Although femoral artery catheterization has been the mainstay of arterial access for cerebral angiography, there has been a recent increase in the use of transradial access among neurointerventionalists. Despite its widespread use among interventional cardiologists, there is a paucity of evidence for its use in the neurosurgical literature. With the constant evolution of device technology and the need of multimodal treatments for complex neurovascular pathologies, most neurointerventionalists resort to femoral artery access because of the vessel’s larger diameter and having been trained with that approach. However, transradial access confers a number of benefits, most notably lower risk of vascular complications, shorter recovery, and increased patient satisfaction and cost reduction. Femoral artery catheterization requires patients to tolerate a painful and uncomfortable procedure, with associated potential complications such as pseudo-aneurysm formation, retroperitoneal hematoma, and artery occlusion. Compared with groin access, radial artery catheterization has been shown to confer a lower risk of local neurovascular complications and improved quality-of-life metrics. This book is the first of its kind, detailing step by step all the technical nuances of the transradial approach in the neurointerventional world, from diagnostic cerebral angiograms to neurointerventional procedures. This is the perfect book for physicians who decided to make the transition of their practice to transradial.

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