Open arterial revascularization of the critically ischemic foot using arterial homograft.

نویسندگان

  • Joseph J Naoum
  • Jean Bismuth
  • Hosam F El-Sayed
  • Mark G Davies
  • Eric K Peden
  • Alan B Lumsden
چکیده

BACKGROUND Revascularization alternatives for patients with critical limb ischemia and without adequate autogenous vein remain challenging. We reviewed our experience with the use of arterial homograft as a conduit for limb salvage in patients with limb ischemia and active lower extremity infections. METHODS A retrospective review of patients who underwent open arterial revascularization of the lower extremity with cryopreserved femoral artery homograft for the treatment of symptomatic critical limb ischemia (i.e., foot ulceration, infection, or gangrene) during an 18-month period was performed. Relevant clinical variables and treatment outcomes were analyzed. Clinical success was defined as limb salvage for one year, patency of the reconstruction, and wound healing. RESULTS Thirteen patients (5 men; average age 71 +/- 83 years, range 51-87 years) were treated during this study period. Treatment indications included 10 (77%) foot ulcerations, 2 (15%) critically ischemic limbs without ulceration, and 1 (8%) infected polytetrafluoroethylene bypass graft with acute occlusion and limb ischemia. A femoral below-the-knee popliteal bypass was performed in 4 (1%), femoral to anterior tibial artery in 4 (31%), femoral to posterior tibial artery in 3 (23%), and femoral to peroneal artery in 2 (15%). All 13 limbs were preserved. Minor amputations were performed in 6 patients, 2 underwent toe amputations and 4 patients had a trans-metatarsal amputation. The cumulative patency rate at 6, 9, and 18 months was 92.3%, 70.3%, and 58.6%, respectively. CONCLUSION Open arterial revascularization with arterial femoral homograft is an acceptable treatment method in patients with critical limb ischemia and active infection in whom autogenous vein is not available or the use of a synthetic conduit is not possible.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The effects of foot massage on physiologic indicators in critically ill patients

The perpuse of this research is to determine the effect of foot massage on physiologic indicators including pulse, respiration and mean arterial pressure. The hypothesis of this research is that foot massage decreases the patient´s heart rate, respiratory rate and mean arterial pressure. This research is a quasiexperimental study and a self-control clinical trial with repeated measures in witch...

متن کامل

The effects of foot massage on physiologic indicators in critically ill patients

The perpuse of this research is to determine the effect of foot massage on physiologic indicators including pulse, respiration and mean arterial pressure. The hypothesis of this research is that foot massage decreases the patient´s heart rate, respiratory rate and mean arterial pressure. This research is a quasiexperimental study and a self-control clinical trial with repeated measures in witch...

متن کامل

Surgical infrainguinal revascularization for peripheral arterial disease: factors affecting patency rate

Background: Peripheral arterial disease is a source of morbidity and mortality. Surgical vascular reconstruction is a treatment option but probability of failure and complications are important concerns. In this study, we evaluated outcome of surgical infrainguinal reconstruction and factors affecting graft patency for a period of one year. Methods: In this cohort study, 85 consecutive patie...

متن کامل

Comparison of the right internal thoracic artery and radial artery as a second arterial conduit in ‘Y’ composite fashion in patients undergoing coronary artery bypass grafting using total arterial revascularization

Introduction: The use of two arterial conduits for CABG is rapidly increasing. The second arterial conduit to LITA is usually RITA or radial artery. We sought to compare outcomes when either RITA or radial artery is exclusively used as a Y composite graft to LITA for total arterial revascularization. Material and methods:  We retrospectively analyzed 231 ...

متن کامل

Results of Infrapopliteal Endovascular Procedures Performed in Diabetic Patients with Critical Limb Ischemia and Tissue Loss from the Perspective of an Angiosome-Oriented Revascularization Strategy

Our aim was to describe our experience with infrapopliteal endovascular procedures performed in diabetic patients with ischemic ulcers and critical ischemia (CLI). A retrospective study of 101 procedures was performed. Our cohort was divided into groups according to the number of tibial vessels attempted and the number of patent tibial vessels achieved to the foot. An angiosome anatomical class...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Le Journal medical libanais. The Lebanese medical journal

دوره 62 3  شماره 

صفحات  -

تاریخ انتشار 2014