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Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report

INTRODUCTION: Peripheral Arterial Disease (PAD) in diabetic patients is a significant cause of Morbility. Long arterial occlusion in patient previously treated can require unusual and complex solution. Herein we report a case of complicated bypass in diabetic patient with history of bypass for bilat...

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Autores principales: Dinoto, E., Bajardi, G., La Marca, M.A., Ferlito, F., Mirabella, D., Pecoraro, F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209681/
https://www.ncbi.nlm.nih.gov/pubmed/34126580
http://dx.doi.org/10.1016/j.ijscr.2021.106103
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author Dinoto, E.
Bajardi, G.
La Marca, M.A.
Ferlito, F.
Mirabella, D.
Pecoraro, F.
author_facet Dinoto, E.
Bajardi, G.
La Marca, M.A.
Ferlito, F.
Mirabella, D.
Pecoraro, F.
author_sort Dinoto, E.
collection PubMed
description INTRODUCTION: Peripheral Arterial Disease (PAD) in diabetic patients is a significant cause of Morbility. Long arterial occlusion in patient previously treated can require unusual and complex solution. Herein we report a case of complicated bypass in diabetic patient with history of bypass for bilateral popliteal aneurysm. PRESENTATION OF CASE: A 51-year-old male, smoker, with hypertension and diabetes mellitus was referred to our hospital for rest pain in left limb and peripheral cyanosis. Ultrasound doppler (US) showed an occlusion after common femoral artery with patency of Anterior-tibial artery (ATA) two centimeters after the origin. The unavailability of adequate autologous conduit necessitated an alternative solution and was chosen a composite femoro-anterior tibial artery bypass with successive ATA angioplasty to ensure the patency of graft. DISCUSSION: The autogenous vein is the preferred conduit in below-knee vascular reconstructions but in redo-procedures in the absence of vein, synthetic or biologic vascular prostheses must be considered as graft material. In these cases tibial angioplasty can improve the outflow and the patency. CONCLUSION: Composite Femoro-ATA bypass with tibial angioplasty is an alternative technique for critically ischemic legs with limited autologous vein material. In our experience this approach was safe and effective.
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spelling pubmed-82096812021-06-23 Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report Dinoto, E. Bajardi, G. La Marca, M.A. Ferlito, F. Mirabella, D. Pecoraro, F. Int J Surg Case Rep Case Report INTRODUCTION: Peripheral Arterial Disease (PAD) in diabetic patients is a significant cause of Morbility. Long arterial occlusion in patient previously treated can require unusual and complex solution. Herein we report a case of complicated bypass in diabetic patient with history of bypass for bilateral popliteal aneurysm. PRESENTATION OF CASE: A 51-year-old male, smoker, with hypertension and diabetes mellitus was referred to our hospital for rest pain in left limb and peripheral cyanosis. Ultrasound doppler (US) showed an occlusion after common femoral artery with patency of Anterior-tibial artery (ATA) two centimeters after the origin. The unavailability of adequate autologous conduit necessitated an alternative solution and was chosen a composite femoro-anterior tibial artery bypass with successive ATA angioplasty to ensure the patency of graft. DISCUSSION: The autogenous vein is the preferred conduit in below-knee vascular reconstructions but in redo-procedures in the absence of vein, synthetic or biologic vascular prostheses must be considered as graft material. In these cases tibial angioplasty can improve the outflow and the patency. CONCLUSION: Composite Femoro-ATA bypass with tibial angioplasty is an alternative technique for critically ischemic legs with limited autologous vein material. In our experience this approach was safe and effective. Elsevier 2021-06-10 /pmc/articles/PMC8209681/ /pubmed/34126580 http://dx.doi.org/10.1016/j.ijscr.2021.106103 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Dinoto, E.
Bajardi, G.
La Marca, M.A.
Ferlito, F.
Mirabella, D.
Pecoraro, F.
Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report
title Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report
title_full Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report
title_fullStr Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report
title_full_unstemmed Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report
title_short Composite femoro-tibial bypass as alternative solution in complicated revascolarization: Case report
title_sort composite femoro-tibial bypass as alternative solution in complicated revascolarization: case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209681/
https://www.ncbi.nlm.nih.gov/pubmed/34126580
http://dx.doi.org/10.1016/j.ijscr.2021.106103
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