Abstract:Objective:To evaluate the outcome of composite sequential bypass in treatment of chronic lower extremity ischemia.
Methods :The clinical data of 25 patients with chronic lower limb ischemia who underwent composite sequential bypass reconstruction, in a 3year period, were retropectively analyzed. The composite vessel consisted of PTFE vassular prosthesis and autologous vein. The proximal end of PTFE was anastomosed to the common femoral artery, and the distal end to the isolated popliteal artery. The autologous vein exited from the lower end of PTFE vessel and was anastomosed to the tibial or peroneal artery in the leg.
Results:The venous reconstructions had the inflow taken from the distal PTFE artery (above knee in 5 and below knee in 20). The outflow involved the peroneal artery in 12 (48%), the posterior tibial artery in 8(32%), and the anterior tibial artery in 5 (20%). Primary patency, secondary patency and limb salvage were 61%, 68% and 73% at 3 year, respectively.
Conclusions:Composite sequential reconstruction using an isolated popliteal segment as supporting point for the distal reconstruction has high longterm patency rate and good effect of limb savage,it is an acceptable option in patients presenting with serious limb ischemia without enough venous conduit for distal bypass.