Download PDF
Thorac Cardiovasc Surg 1985; 33(3): 146-156
DOI: 10.1055/s-2007-1014106
© Georg Thieme Verlag Stuttgart · New York

Experience with 350 Crural Arterial Reconstructions: Analysis and Conclusions

J. Largiadèr
  • Surgical Department B, Division of Peripheral Vascular Surgery, University Hospital, Zürich, Switzerland
Further Information

Publication History

1984

Publication Date:
08 May 2008 (online)

  PDF Download  Permissions and Reprints All articles of this category

Summary

Distal arterial reconstructions differ from those in the pelvic and femoral region in the following 3 characteristics:

  • wound healing is endangered by ischemic tissue;

  • vessel diameters are very small;

  • poor outflow conditions can reduce blood flow velocity in the long femorocrural grafts thus increasing the risk of reocclusion.

On the basis of clinical and angiographic follow-up studies we investigated retrospectively various factors influencing the long-term results:

  • bypass material;

  • poor outflow;

  • technique of distal insertion;

  • location of the bypass graft.

Conclusions:

  • autologous vein provides the best, umbilical vein the second best arterial substitute. Prosthetic material is less satisfactory.

  • AV-fistulae can be successfully employed to reduce peri pheral outflow resistance;

  • Short bypass lengths can be achieved by proximal end-to-side and distal end-to-end anastomoses;

  • orthotopic location of the bypass yields the best long-term results.

Key words

Femoro-crural bypass - Operative technique - AV-fistula

      >