Outcomes of complex femorodistal sequential autologous vein and biologic prosthesis composite bypass grafts Achim Neufang, MD, PhD, Bernhard Dorweiler,

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Presentation transcript:

Outcomes of complex femorodistal sequential autologous vein and biologic prosthesis composite bypass grafts Achim Neufang, MD, PhD, Bernhard Dorweiler, MD, PhD, Christine Espinola-Klein, MD, PhD, Savvas Savvidis, MD, Marco Doemland, MD, Sebastian Schotten, MD, Christian Friedrich Vahl, MD, PhD Journal of Vascular Surgery Volume 60, Issue 6, Pages 1543-1553 (December 2014) DOI: 10.1016/j.jvs.2014.07.103 Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 1 Configuration types of 122 sequential composite bypasses (SCBs) with a biologic prosthesis and autologous vein: (a) serial anastomoses, (b) bridge technique, (c) jump graft, (d) inverted Y graft with natural bifurcation, and (e) “secondary bridge.” Journal of Vascular Surgery 2014 60, 1543-1553DOI: (10.1016/j.jvs.2014.07.103) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 2 Survival of 67 men and 49 women operated on with human umbilical vein (HUV)–vein and Omniflow II–vein sequential composite bypasses (SCBs). SE, Standard error. Journal of Vascular Surgery 2014 60, 1543-1553DOI: (10.1016/j.jvs.2014.07.103) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 3 Sequential composite bypass (SCB) with human umbilical vein (HUV) and greater saphenous vein (bridge technique with three distal anastomoses: popliteal artery, posterior tibial artery, and dorsalis pedis artery) 158 months postoperatively. Note the aneurysmal degeneration of the distal part of the HUV with implanted self-expandable stent in a stenotic HUV segment (arrows). Patency of all distal anastomoses is unimpaired. (Reproduced with permission of Peter von Flotow, MD, Department of Angiology, Westpfalz Klinikum Kusel, Germany.) Journal of Vascular Surgery 2014 60, 1543-1553DOI: (10.1016/j.jvs.2014.07.103) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 4 Primary patency in 90 human umbilical vein (HUV)–vein and 32 Omniflow II–vein sequential composite bypasses (SCBs). SE, Standard error. Journal of Vascular Surgery 2014 60, 1543-1553DOI: (10.1016/j.jvs.2014.07.103) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 5 Secondary patency in 90 human umbilical vein (HUV)–vein and 32 Omniflow II–vein sequential composite bypasses (SCBs). SE, Standard error. Journal of Vascular Surgery 2014 60, 1543-1553DOI: (10.1016/j.jvs.2014.07.103) Copyright © 2014 Society for Vascular Surgery Terms and Conditions

Fig 6 Limb salvage in 120 limbs operated on with human umbilical vein (HUV)–vein and Omniflow II–vein sequential composite bypasses (SCBs). SE, Standard error. Journal of Vascular Surgery 2014 60, 1543-1553DOI: (10.1016/j.jvs.2014.07.103) Copyright © 2014 Society for Vascular Surgery Terms and Conditions