title: The use of endografts to create an endoluminal femoropopliteal bypass after failed above-knee femoropopliteal open bypass surgery.
abstract: Redo femoropopliteal bypass surgery is associated with increased morbidity and related to a poorer outcome than primary procedures. Endografts might provide an alternative, avoiding dissection of a previously operated groin. Patients treated with a polytetrafluoroethylene-covered stents for superficial femoral artery occlusive disease between February 2009 and September 2011 were prospectively gathered. Demographics, clinical status, procedural aspects, and follow-up were retrieved. Seventy-four patients were included of which 5 (7%) were treated before with a femoropopliteal bypass. Indication for intervention was Rutherford category 3 in all patients and the median ankle-brachial index (ABI) was 0.68. Technical success was achieved in all cases. The postoperative course was uneventful in all and the ABI increased to 0.95. After a follow-up period of 18 months, 4 of 5 endografts remained patent. The use of endografts after failed femoropopliteal bypass surgery is feasible and safe and could be used to avoid or minimize a difficult and hazardous dissection of a previously operated area.
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: M M A
authors.initials: MM
authors.lastname: Lensvelt
authors.forename: O R M
authors.initials: OR
authors.lastname: Wikkeling
authors.forename: J A
authors.initials: JA
authors.lastname: Van Oostayen
authors.forename: J G
authors.initials: JG
authors.lastname: Roukema
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: M M P J
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D015607:Stents; D013997:Time Factors; D017211:Treatment Failure; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects
chemical_list: D011138:Polytetrafluoroethylene