[Extraanatomic bypass surgery for peripheral arterial vascular disease--is it still justified?].
OBJECTIVE
Our results of extraanatomic bypass surgery in the last 5 years should be analysed in a retrospective study.


METHODS
66 extraanatomic reconstructions were performed in 65 patients (52 male, 13 female). Femoro-femoral bypasses (78.8 %) were mainly included in this study, followed by axillo-femoral (bifemoral) and obturator bypasses. The procedures could be divided in 45 (68.2 %) primary and 21 (31.8 %) recurrent operations. 57.6 % of the patients revealed a critical lower limb ischemia.


RESULTS
The bypass patency rates were 97 % after one year and 81.1 % after 3 years. 24.2 % of the patients showed immediate postoperative complications, 12.1 % of them major complications (surgical and nonsurgical). No patient died postoperatively or in the first year after operation. The 3-year mortality rate ranged to 10.8 %. Major amputations had to be carried out in 4 patients (6.1 %) during the first year and in one patient later on, so that the total amputation rate amounted to 7.6 %.


CONCLUSIONS
Our results prove extraanatomic reconstructions to be a valuable surgical tool in lower limb ischemia with good long-term success. Extraanatomic bypasses are technically simple procedures in the majority of cases and take good care of the patient with low morbidity and mortality.
Cechura
M
M
Chirurgische Universitätsklinik des Fakultätskrankenhauses in Pilsen. Cechura@fnplzen.cz
Treska
V
V
Krizan
J
J
Certik
B
B
Kuntscher
V
V
Sulc
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery*; D001366:Axillary Artery / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation / Q000401:mortality; D015996:Survival Rate