Endovascular placement of an extraluminal femoropopliteal bypass graft in human cadavers.
OBJECTIVE
A method to create an extraluminal femoropopliteal bypass graft using endovascular techniques was evaluated in situ on cadaver extremities in an attempt to develop a minimally invasive alternative technique for the management of infrainguinal occlusive arterial disease.


METHODS
The endovascular placement of an extraluminal femoropopliteal bypass graft was undertaken in 5 cadaver legs. Following percutaneous access to the popliteal artery (PA) or common femoral artery (CFA), a Rosch-Uchida needle was used to perforate the vascular wall, followed by the creation of an extraluminal tract using a looped wire and catheter. Once the desired level was reached the needle was again used to perforate the vascular wall of the proximal superficial femoral artery (SFA) or PA depending on the access used. Self-expanding expanded polytetrafluoroethylene (ePTFE) stent-grafts were then deployed to establish the extraluminal femoropopliteal bypass connecting the two arterial puncture sites. Following dilatation of the stent-graft, angiography was performed to assess the endoprostheses and to look for contrast leaks.


RESULTS
Technical success was achieved in all 5 legs. Procedure time varied from 15 to 30 min. The angiographic studies performed immediately after completion of the bypass procedure showed patency of the grafts with no evidence of kinking or leakage in any of the cases.


CONCLUSIONS
This study has proved that the endovascular placement of an extraluminal femoropopliteal bypass graft in human cadaver legs using endovascular techniques under fluoroscopic control is technically feasible.
Maynar
Manuel
M
Divisions of Vascular Surgery and Endovascular Surgery, Institute of Diagnosis and Minimally Invasive Therapy, Santa Cruz de Tenerife, Spain.
Llorens
Rafael
R
Uson-Gargallo
Jesus
J
Crisostomo
Veronica
V
Lopez-Sanchez
Carmen
C
Garcia-Martinez
Virginio
V
Qian
Zhong
Z
Lopera
Jorge
J
Castañeda
Wilfrido R
WR
D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D002102:Cadaver; D002406:Catheterization, Peripheral / Q000295:instrumentation; D003287:Contrast Media; D005240:Feasibility Studies; D005263:Femoral Artery / Q000601:surgery*; D005471:Fluoroscopy; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009339:Needles; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery*; D011677:Punctures / Q000295:instrumentation; D015607:Stents; D013997:Time Factors; D014654:Vascular Patency
D003287:Contrast Media; D011138:Polytetrafluoroethylene