Bypass to the genicular arteries for revascularisation of the lower limb.

Abstract

OBJECTIVE:

To describe an initial experience with infrainguinal bypass grafts inserted distally in a genicular artery.

DESIGN:

Retrospective case series study.

SUBJECTS AND METHODS:

Eleven patients with Grade III chronic limb ischaemia in whom arteriography showed femoropopliteal occlusive disease and at least one genicular branch suitable for receiving a bypass. Bypass grafts were done to the descending genicular artery (n=4) or the medial sural artery (n=6) using segments of autologous veins; one bypass was not completed.

RESULTS:

Primary graft patency and foot salvage rates were 73% at 1 month and 24 months of follow-up. Patient survival rate was 100% and 90%, respectively. Major amputation was required in two of three patients following early graft failure. Of the eight patients who had a patent graft, the Doppler ankle-brachial systolic pressure index showed no change in one patient, an increase of 0.13-0.66 in six patients, and was not measured in one patient. The former patient underwent a below-knee amputation whereas the other seven patients showed complete healing of their skin ulcers and sites of minor amputation.

CONCLUSION:

The genicular bypass is a useful alternative that may extend the limits of infrainguinal arterial reconstruction with autologous tissue and the potential for long-term patient benefit.

• Authors: F C Brochado Neto, J Gonzalez, M Cinelli Jr, M Albers
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 20 Issue 6 Pg. 545-9 (Dec 2000) ISSN: 1078-5884 [Print] England
• PMID: 11136590 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Arteries (surgery)
• Female
• Humans
• Ischemia (surgery)
• Knee (blood supply)
• Leg (blood supply)
• Male
• Middle Aged
• Reoperation
• Retrospective Studies
• Veins (transplantation)