A comparison of endovascular assisted and conventional in situ bypass grafts

Dolores F. Cikrit, Nicholas F. Fiore, Michael C. Dalsing, Stephen G. Lalka, Alan P. Sawchuk, Alan P. Ladd, Shannon Dodson

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Thirty-three in situ saphenous vein bypass grafts were performed using a conventional open technique (CI) while 31 in situ bypass grafts were performed using endovascular occlusion of side branches (EAI). Bypass grafts were performed from the femoral to the popliteal (n=37) or a trifurcation (n=27) artery for claudication (n=7), rest pain (n=14), or tissue loss (n=43). Wound complications developed in 11 Cl and four EAl limbs. Postoperative hospitalization in CI and EAI patients was, respectively, 8.4±2.0 days and 4±1.6 days. Missed arteriovenous fistulas were noted in one CI and 17 EAI limbs postoperatively. At follow-up four (12%) CI and six (19%) EAI grafts were occluded or had undergone revision surgery. Based on life-table analysis CI and EAI cumulative patency rates at 18 months were 79% and 83%, respectively. Although this new technique (EAI bypass grafting) did not reduce operative time, it did decrease the length of surgical incisions and the duration of postoperative hospitalization (p < 0.001, Student's t test). Wound complications occurred less frequently in EAI limbs but the incidence of missed arteriovenous fistulas was significantly higher. These data suggest that EAI and CI patency is comparable. Ultimately long-term patency will be the crucial test for determining the utility of this new technique.

Original languageEnglish (US)
Pages (from-to)37-43
Number of pages7
JournalAnnals of Vascular Surgery
Volume9
Issue number1
DOIs
StatePublished - Jan 1995

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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