Extra-anatomic bypass surgery for critical leg ischemia. A review.
Since an aggressive revascularisation policy for critical limb ischemia (CLI) has been shown to lower morbidity and mortality, to improve quality of life and to be cost-effective in comparison to amputation, extra-anatomic bypass (EAB) grafts may be indicated whenever hostile local conditions or severe medical diseases contraindicate an aortofemoral reconstruction. Most series report limb-salvage rates markedly higher than the related patency rates, as revascularisations may often heal the ischemic extremity before the graft occludes. A large review of data from the literature suggests that EAB grafting for CLI may achieve gratifying results in a subgroup of patients with multilevel obstructive disease and not suitable for conventional aortofemoral repair.
Biancari
F
F
III Department of Surgery University La Sapienza, Rome, Italy.
Lepäntalo
M
M
D001366:Axillary Artery / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D001808:Blood Vessels / Q000637:transplantation*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D011150:Popliteal Artery / Q000601:surgery*; D013895:Thoracic Arteries / Q000601:surgery*; D014654:Vascular Patency