title: Composite sequential bypass using profunda vein hitchhike.
abstract: Patients with long-segment occlusions of the iliac and femoral arteries often undergo sequential bypass procedures. There exists a subgroup of patients who have no suitable vessels in the groin. We report our experience with a new technique of using the profunda vein as a hitchhike point in our series of seven patients (eight limbs) with critical ischemia and occlusion at the iliac or aortic level with reformation of infrageniculate arteries and no reformation in the groin. The proximal graft was anastomosed to the profunda vein, which was ligated proximal to the anastomosis. The saphenous vein graft was taken from the distal end of the polytetrafluoroethylene graft and anastomosed to the appropriate tibial arteries. The procedure was technically successful in all the patients. The median follow-up was 8 months (range, 0-30). The profunda vein as a hitchhike point gives an excellent outcome in the short and medium term in this uncommon group of patients.
authors.affiliation: Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India. Electronic address: rrkrishnan@hotmail.com.
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Raju
authors.affiliation: Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India.
authors.forename: Kapil
authors.initials: K
authors.lastname: Mathur
authors.affiliation: Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India.
authors.forename: Makkathai Kanakasabai
authors.initials: MK
authors.lastname: Ayyappan
authors.affiliation: Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India.
authors.forename: Jayanth
authors.initials: J
authors.lastname: Vijayakumar
authors.affiliation: Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India.
authors.forename: Vishnukumar
authors.initials: V
authors.lastname: Venkatesan
authors.affiliation: Department of Vascular Surgery, Sri Ramachandra University, Porur, Chennai, India.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Venkatachalapathy
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D000072226:Computed Tomography Angiography; D016638:Critical Illness; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012501:Saphenous Vein / Q000637:transplantation*; D016909:Tibial Arteries / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D011138:Polytetrafluoroethylene