Walter J. McCarthy, MD, Charles L. Mesh, MD, William D

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Presentation transcript:

Descending thoracic aorta-to-femoral artery bypass: Ten years' experience with a durable procedure Walter J. McCarthy, MD, Charles L. Mesh, MD, William D. McMillan, MD, William R. Flinn, MD, William H. Pearce, MD, James S.T. Yao, MD, PhD Journal of Vascular Surgery Volume 17, Issue 2, Pages 336-348 (February 1993) DOI: 10.1016/0741-5214(93)90419-M Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Aortic access can be obtained by directly puncturing existing axillary grafts. This right axillary graft allows retrograde catheter passage into ascending aorta. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Direct needle puncture of axillary grafts is used to define arterial anatomy beyond distal anastomosis. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Angiogram demonstrates origin of 10 mm graft placed several centimeters above diaphragm. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Computed tomographic scan demonstrates thoracic aorta-femoral artery graft in left anterior retroperitoneum anterior to left kidney. Thrombosed axillopopliteal bypass grafts are apparent subcutaneously on either side. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Life table of thoracic aorta-to-femoral artery bypass patency. Patency after standard error exceeds 10% with dotted line. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Life table of patient survival after date of thoracic aorta-to-femoral artery bypass. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Patients occasionally required additional femoral reconstructive arterial operation. This patient returned 1 year after original operation with left limb ischemia. Journal of Vascular Surgery 1993 17, 336-348DOI: (10.1016/0741-5214(93)90419-M) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions