Bypass to the perigeniculate collateral arteries: mid-term results.
OBJECTIVE
The purpose of this report is to present mid-term results of infrainguinal revascularizations using either the highest genicular artery or medial sural artery as the distal anastomosis site.


METHODS
Between 1996 and 2005, a total of 59 bypass procedures to perigeniculate collateral arteries were performed in 57 patients (14 women, 43 men) with a mean age of 74. Fifty five patients presented with critical ischemia (tissue loss in 28 and rest pain in 27). Four patients presented with intermittent claudication. Mean ankle brachial index was 0.48. The distal anastomosis site was the highest genicular artery in 18 patients, medial sural artery in 37 cases, highest genicular and/or medial sural artery and/or tibial artery in sequential fashion in four cases. The proximal anastomosis was to the common femoral artery in 26 cases and superficial femoral artery in 33.


RESULTS
There were two deaths during the immediate postoperative period. Mean follow-up duration was 35 months (range 1-108 months). One patient was lost to follow-up. Six patients required major amputation. At 3 years, primary patency was 65+/-7%, secondary patency was 70+/-7%, limb salvage and survival rate were 90+/-4% and 64+/-7% respectively.


CONCLUSIONS
Bypass to perigeniculate collateral arteries provides acceptable patency and limb salvage rates.
de Latour
B
B
Service de Chirurgie Cardiovasculaire, Hôpital Nord St Etienne, 42055 Saint Etienne, Cedex 2, France.
Nourissat
G
G
Duprey
A
A
Berger
L
L
Favre
J P
JP
Barral
X
X
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003097:Collateral Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery*; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*