Flow dynamics across end-to-end vascular bypass graft anastomoses

1993 ◽  
Vol 21 (4) ◽  
pp. 311-320 ◽  
Author(s):  
Y. H. Kim ◽  
K. B. Chandran ◽  
T. J. Bower ◽  
J. D. Corson
Keyword(s):  
Bypass Graft ◽  
Flow Dynamics ◽  
Vascular Bypass ◽  
End To End

scholarly journals Pedicled omentum for coverage of extra-abdominal vascular bypass graft in the groin

2018 ◽  
Vol 5 (11) ◽  
pp. 44
Author(s):  
Neal G. Moores ◽  
Christopher J. Pannucci
Keyword(s):  
Bypass Graft ◽  
Vascular Bypass

Management of Early Groin Vascular Bypass Graft Infections With Sartorius and Rectus Femoris Flaps

2004 ◽  
Vol 52 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Amy S. Colwell ◽  
Magruder C. Donaldson ◽  
Michael Belkin ◽  
Dennis P. Orgill
Keyword(s):  
Bypass Graft ◽  
Rectus Femoris ◽  
Vascular Bypass

Adolescent coarctation of aorta treated with subclavian-descending aorta bypass grafting

2014 ◽  
Vol 25 (7) ◽  
pp. 1290-1292 ◽  
Author(s):  
Skander Benomrane ◽  
Khedija Soumer ◽  
Adel Khayati
Keyword(s):  
Aortic Coarctation ◽  
Bypass Graft ◽  
Good Condition ◽  
Lower Limbs ◽  
Coarctation Of Aorta ◽  
Bypass Grafting ◽  
Older Children ◽  
Adolescent Patients ◽  
Aorta Bypass ◽  
End To End

AbstractBackgroundAortic coarctation in older children most frequently represents cases of re-coarctation following previous transcatheter or surgical therapy or missed cases of native coarctation.MethodsWe describe three cases of adolescents – two girls and one boy – with aortic coarctation, operated between January, 2012 and December, 2013. Computed tomography angiography was performed as an essential diagnostic procedure.ResultsHypertension was detected, and weaker arterial pulses in the lower limbs were noted in all cases. All operations were performed via left posterolateral thoracotomy. Aortic coarctation was treated surgically, with left subclavian-lower descending thoracic aorta bypass grafting. Postoperative course was uneventful in all cases. No residual brachial-ankle pressure gradient was observed, and all patients have remained in good condition after the operation.ConclusionsSurgical treatment of aortic coarctation in adolescent patients can be achieved by resection with end-to-end anastomosis, interposition of a graft or bypass graft across the area of coarctation when the distance to be bridged is too long for end-to-end repair.The extra-anatomic subclavian-descending aortic bypass grafting provides good results in adolescent patients, particularly in those with complex coarctation.

Mind the gap: A novel endovascular technique to repair a transected vessel

Vascular ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 436-440
Author(s):  
Joanna Kee-Sampson ◽  
Erik Eadie ◽  
Jerry Matteo ◽  
Naudare Shabandi ◽  
Travis Meyer ◽  
...  
Keyword(s):  
High Speed ◽  
Bypass Graft ◽  
Penetrating Trauma ◽  
Critically Ill Patient ◽  
Limiting Factor ◽  
Covered Stents ◽  
Vascular Bypass ◽  
Procedural Time ◽  
Endovascular Approach ◽  
Steerable Microcatheter

Level one trauma centers experience horrific injuries on a regular basis. Blunt or penetrating trauma causing vascular injuries are treated by surgeons and interventional radiologists. When a blood vessel is completely transected, the ends of the vessel retract and vasospasm occurs as a normal survival response. When this phenomenon occurs, it is sometimes impossible to reattach the two ends of the injured vessel by surgical means and a bypass graft is often required. However, from an endovascular perspective, covered stents can serve as a vascular bypass as well. The limiting factor with an endovascular approach is the ability to successfully gain wire access across the injured vessel. The technique described in this manuscript describes a “rendezvous” method of repairing a transected axillosubclavian artery from a high-speed motorcycle accident using a steerable microcatheter. Initially, multiple failed attempts to cross the injured vessel were encountered despite using a wide variety of conventional guidewires and catheters. A steerable microcatheter was then used to safely and effectively navigate more than 15 cm through soft tissue to the opposite end of the vessel. In this critically ill patient, this technique significantly reduced the procedural time when compared to our previous experiences repairing arterial transections using traditional catheters.

The Effect of Proximal Artery Flow on the Hemodynamics at the Distal Anastomosis of a Vascular Bypass Graft: Computational Study

2001 ◽  
Vol 123 (3) ◽  
pp. 277-283 ◽  
Author(s):  
Stephanie M. Kute ◽  
David A. Vorp
Keyword(s):  
Flow Condition ◽  
Stokes Equations ◽  
Bypass Graft ◽  
Distal Anastomosis ◽  
Retrograde Flow ◽  
Vascular Bypass ◽  
Flow Through ◽  
Artery Flow ◽  
Flow Case ◽  
Zero Flow

The formation of distal anastomotic intimal hyperplasia (IH), one common mode of bypass graft failure, has been shown to occur in the areas of disturbed flow particular to this site. The nature of the flow in the segment of artery proximal to the distal anastomosis varies from case to case depending on the clinical situation presented. A partial stenosis of a bypassed arterial segment may allow residual prograde flow through the proximal artery entering the distal anastomosis of the graft. A complete stenosis may allow for zero flow in the proximal artery segment or retrograde flow due to the presence of small collateral vessels upstream. Although a number of investigations on the hemodynamics at the distal anastomosis of an end-to-side bypass graft have been conducted, there has not been a uniform treatment of the proximal artery flow condition. As a result, direct comparison of results from study to study may not be appropriate. The purpose of this work was to perform a three-dimensional computational investigation to study the effect of the proximal artery flow condition (i.e., prograde, zero, and retrograde flow) on the hemodynamics at the distal end-to-side anastomosis. We used the finite volume method to solve the full Navier–Stokes equations for steady flow through an idealized geometry of the distal anastomosis. We calculated the flow field and local wall shear stress (WSS) and WSS gradient (WSSG) everywhere in the domain. We also calculated the severity parameter (SP), a quantification of hemodynamic variation, at the anastomosis. Our model showed a marked difference in both the magnitude and spatial distribution of WSS and WSSG. For example, the maximum WSS magnitude on the floor of the artery proximal to the anastomosis for the prograde and zero flow cases is 1.8 and 3.9 dynes/cm2, respectively, while it is increased to 10.3 dynes/cm2 in the retrograde flow case. Similarly, the maximum value of WSSG magnitude on the floor of the artery proximal to the anastomosis for the prograde flow case is 4.9 dynes/cm3, while it is increased to 13.6 and 24.2 dynes/cm3, respectively, in the zero and retrograde flow cases. The value of SP is highest for the retrograde flow case (13.7 dynes/cm3) and 8.1 and 12.1 percent lower than this for the prograde (12.6 dynes/cm3) and zero (12.0 dynes/cm3) flow cases, respectively. Our model results suggest that the flow condition in the proximal artery is an important determinant of the hemodynamics at the distal anastomosis of end-to-side vascular bypass grafts. Because hemodynamic forces affect the response of vascular endo- thelial cells, the flow situation in the proximal artery may affect IH formation and, therefore, long-term graft patency. Since surgeons have some control over the flow condition in the proximal artery, results from this study could help determine which flow condition is clinically optimal.

scholarly journals Reservoir ofCandidaalbicansinfection in a vascular bypass graft demonstrates a stable karyotype over six months

2004 ◽  
Vol 42 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Paul Lephart ◽  
Patricia Ferrieri ◽  
Jo-anne Van Burik
Keyword(s):  
Bypass Graft ◽  
Vascular Bypass

Forefoot Amputation with Limb Revascularization: The Effects of Amputation, Timing, and Wound Closure on the Peripheral Vascular Bypass Graft Site

2007 ◽  
Vol 28 (6) ◽  
pp. 690-694 ◽  
Author(s):  
Maxwell W. Steel ◽  
James K. DeOrio
Keyword(s):  
Wound Closure ◽  
Bypass Graft ◽  
Graft Infection ◽  
Wound Dehiscence ◽  
Healing Time ◽  
Team Approach ◽  
Arterial Bypass ◽  
Secondary Intention ◽  
Vascular Bypass ◽  
Forefoot Amputation

Background: Much has been written about the effects of successful arterial bypass on forefoot surgery for ulceration and gangrene. This study examined the effects of the amputation site and timing on the arterial bypass graft site. Methods: We reviewed the records of all patients who had successful vascular bypass graft surgery and amputation at our institution, between October, 1995 and May, 2002. Thirty-eight procedures in 35 patients fit the criteria and were included in the study. Results: Thirty-five patients had successful vascular bypass graft surgery and forefoot amputation for gangrene or nonhealing ulceration. Three of these patients developed gangrene on the contralateral side and received similar treatment for that side. All of the wounds eventually healed. Healing time, rate of graft infection, and rate of wound dehiscence did not differ noticeably between patients with amputation immediately after arterial bypass and patients with amputation one or more days after arterial bypass. Infection at the bypass site occurred in two patients; their amputation sites were closed primarily. Wound dehiscence developed at the bypass site in one patient whose amputation site was closed by secondary intention. Although not statistically significant, the median healing time in patients treated with primary closure (37 days) was less than that in patients treated with closure by secondary intention (61 days; p = 0.09), and rates of graft infection and wound dehiscence did not differ between these two groups of patients. Conclusions: Amputation site wound closure may adversely affect the bypass graft, but results were not statistically significant. Treatment requires a closely coordinated team approach between the vascular surgeon and the orthopedic surgeon.

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