scholarly journals A Case of Upper Limb Salvage by Bypass Grafting from Ascending Aorta to Bibrachial Artery Using Composite Y-type Artificial Vessel and Great Saphenous Vein for Severe Upper Limb Ischemia

2017 ◽  
Vol 57 (4) ◽  
pp. 63-67
Author(s):  
Masahiro Sagane ◽  
Hiroshi Furukawa ◽  
Hiroyuki Abe ◽  
Toshiya Kobayashi
Keyword(s):  
Limb Salvage ◽  
Upper Limb ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Limb Ischemia ◽  
Ascending Aorta ◽  
Bypass Grafting ◽  
Artificial Vessel ◽  
Grafting From

OFF-PUMP CORONARY ARTERY BYPASS GRAFTING WITHOUT MANIPULATION OF THE ASCENDING AORTA USING A NON-SKELETONIZED GREAT SAPHENOUS VEIN IN PATIENTS WITH MULTIVESSEL ATHEROSCLEROTIC CORONARY ARTERY DISEASE

2021 ◽  
Vol 5 (1) ◽  
pp. 1161-1166
Author(s):  
A. Charniak ◽  
◽  
V. Podpalov ◽  
K. Rubakhov ◽  
O. Kozak ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Ascending Aorta ◽  
Surrounding Tissue ◽  
Bypass Grafting ◽  
Perioperative Myocardial Infarction ◽  
Artery Disease

Objective. To compare early postoperative hospital and one-year outcomes of coronary artery bypass grafting on a "working heart" (OPCABG) and coronary bypass grafting without manipulation of the ascending aorta (anCABG) in patients with multivessel atherosclerotic coronary artery disease. Methods. The object of the prospective, single-center, randomized study was 80 patients with multivessel atherosclerotic coronary artery lesions who underwent myocardial revascularization at Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology in 2018-2020. One group consisted of the patients (38 people) who underwent anCABG using composite grafts and great saphenous vein harvested "with surrounding tissue". The second group (42 patients) consisted of the patients who underwent OPCABG. Results. Two observation groups did not differ significantly according to the main initial variables. The severity of coronary lesions according to SYNTAX Score was 25.1±6.15 in the anCABG group and 24.3±7.47 in the OPCABG group (p>0.05). All patients underwent complete myocardial revascularization. The number of distal anastomoses was 2.66±0.68 in the anCABG group and 2.36±0.48 in the OPCABG group (p>0.05). There was no in-hospital mortality in either group. Perioperative myocardial infarction occurred in two patients in the OPCABG group and one patient in the anCABG group. One patient in the OPCABG group had an atherothrombotic stroke and another patient developed a transient ischemic attack. Time of stay both in the intensive care unit after the operation and in the cardiac surgery inpatient department was significantly longer in the OPCABG group (p<0.05). Conclusion. The anCABG method showed advantages in comparison with OPCABG at the early postoperative inpatient stage in patients with multivessel atherosclerotic lesions of the coronary arteries. It was expressed in lower frequency of neurological complications and perioperative myocardial infarction and statistically shorter time of stay in intensive care unit and cardiac surgical inpatient department (p<0.05). In the long-term period there was lower incidence of venous graft dysfunction in the anCABG group using large saphenous vein harvested "with surrounding tissue", it being expressed in the reduced frequency of major adverse cardiovascular events.

Result of bypass grafting for upper limb ischemia

1986 ◽  
Vol 3 (5) ◽  
pp. 741-746 ◽  
Author(s):  
Walter J. McCarthy ◽  
William R. Flinn ◽  
James S. T. Yao ◽  
Larry R. Williams ◽  
John J. Bergan
Keyword(s):  
Upper Limb ◽  
Limb Ischemia ◽  
Bypass Grafting

Preliminary six-month outcomes of LIMBSAVE (treatment of critical Limb IscheMia with infragenicular Bypass adopting in situ SAphenous VEin technique) registry

Vascular ◽  
2020 ◽  
pp. 170853812096612 ◽  
Author(s):  
Nicola Troisi ◽  
Giovanni De Blasis ◽  
Mauro Salvini ◽  
Stefano Michelagnoli ◽  
Carlo Setacci ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Critical Limb Ischemia ◽  
Saphenous Vein ◽  
Limb Ischemia ◽  
Primary Patency ◽  
Secondary Patency ◽  
Bypass Patency ◽  
The Mean

Objectives Guidelines recommend open bypass surgery for long occlusions of infrainguinal arteries. In situ saphenous vein bypass is a standardized technique. The aim of this study was to report preliminary six-month outcomes of a national, multicenter, observational, prospective registry based on the examination of treatment of critical Limb IscheMia with infragenicular Bypass adopting the in situ SAphenous VEin technique (LIMBSAVE). Methods From January 2018 until October 2019, 428 patients from 41 centers were enrolled in the LIMBSAVE registry. Data were prospectively collected in a dedicated database, including demographics, preoperative risk factors, clinical and diagnostic preoperative assessments, intraoperative measures (including safety and effectiveness of the valvulotome during the surgical procedures), and 30-day follow-up data. Furthermore, estimated six-month outcomes according to Kaplan–Meier curves in terms of primary patency, primary assisted patency, secondary patency, and limb salvage were evaluated. Results Patients were predominantly male ( n = 332, 77.6%) with a mean age of 73.3 years (range 39–95). Technical success, defined as bypass pulse after use of the valvulotome, was obtained in all cases. The proximal anastomosis could be reached by the valvulotome in all cases. The mean number of valvulotome uses was 2.5 (range 1–5). No vein perforation was reported. In nine cases (2.1%), a vein lesion with intramural hemorrhage occurred. The mean length of hospital stay was 11.1 days (range 1–60). At 30-day follow-up, the overall bypass patency rate was 97.4%, and the rate of open or endo reinterventions for failing bypass was 5.4%. At six-month follow-up, the estimated primary patency, primary assisted patency, secondary patency, and limb salvage were 78.1%, 86.2%, 92.1%, and 94.7%, respectively. Conclusions Preliminary intraprocedural outcomes of the LIMBSAVE registry show that the in situ technique with the valvulotome is safe and effective in disrupting valves and obtaining pulsatility in the saphenous vein. The complication rate related to the use of the valvulotome is low. The six-month preliminary outcomes in terms of overall patency and limb salvage are promising. Further examinations and continuous follow-up are needed to evaluate long-term outcomes.

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