Abstract:

Objective: Atherosclerosis and thrombotic disorders disrupts distal limb perfusion and threatens organ viability. The distal flow should be provided with interventional or surgical procedures. However, it is not possible every time due to the loss of normal anatomical conditions. Extra-anatomic ways can be used for providing distal blood supply in such these conditions. In current study we aimed to present our extra-anatomic bypass applications in cases who has not chance for anatomical revascularization. Method: Extra-anatomic bypass intervention was applied to medical cases in our clinic between 2010 and 2018. Age, sex and accompanying diseases were recorded retrospectively. The polytetrafluoroethylene (PTFE) or otogenous saphenous vein graft was used for extra-anatomic revascularization. Results: Nine (75%) of the patients were male and 3 of them (25%) were female. The mean age of the patients was 56.08 years. Lower extremity revascularization was performed in all cases. For the lower extremity, a femoro-femoral bypass in eight cases, an axillo-femoral bypass in two cases, and femoro-infrapopliteal bypass 18 in two cases were performed respectively. Two (18%) complications were encountered in the immediate postoperative period. Late-period mortality was not observed during the follow-up period. In terms of late-period morbidity (6 months after surgery), graft thrombosis was observed in one case. Conclusion: Although the increase in the number of endovascular interventions in recent years restricts surgical intervention, extra-anatomic bypass procedures should be considered as an alternative surgical approach in cases with co-morbidity factors such as previous vascular bypass surgery, diabetes, and obesity etc.

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