Objective: This study is evaluating the effectiveness of salvage interventions to rescue threatened infra-popliteal (IP) bypasses in critical limb ischemia (CLI) patients. Materials and methods: Data of all CLI patients who underwent distal IP bypasses at a single institution between 2016 and 2021 are analysed retrospectively. Patency rates, amputation-free survival, patient survival, and wound healing rates after a 1-year follow-up period are calculated. Comparative analyses of amputation free survival and patient survival rates between non-threatened, threatened and acutely occluded grafts are also done. Results: A total of 121 IP bypasses were performed in 115 patients (84 male; mean age, 74.4±8; hypertension, 84%; diabetes mellitus, 69%). 24% originated from the common femoral artery, 40% from the superficial femoral artery and 36% from the popliteal artery. The most common outflow arteries are the anterior tibial artery (36%) and the posterior tibial artery (33%). Secondary interventions in the form of endovascular and surgical revisions are necessitated in 53 (44%) grafts. At one-year follow-up, primary, assisted-primary, and secondary patency rates are 50%, 78% and 88%, respectively. Amputation-free survival and patient survival rates are 93% and 86%, respectively. Complete wound healing rate is 83%. Amputation-free survival among acutely occluded grafts is significantly worse when compared with threatened and non-threatened grafts (P-value<0.001). Conclusion: Secondary interventions to rescue threatened distal bypasses are successful at maintaining graft patency with amputation-free survival rate comparable to non-threatened grafts. Salvage angioplasty is a viable alternative to surgical revision to rescue limbs with threatened grafts in CLI patients.
Soliman, M., Elsabbagh, M., Elshimy, W., & Salem, A. (2023). Effectiveness of Secondary Interventions to Rescue Threatened Distal Bypasses for Limb Salvage. Ain Shams Journal of Surgery, 16(3), 225-234. doi: 10.21608/asjs.2023.309406
MLA
Mahmoud A. Soliman; Mahmoud Ahmed Elsabbagh; Wael Elshimy; Ayman Salem. "Effectiveness of Secondary Interventions to Rescue Threatened Distal Bypasses for Limb Salvage". Ain Shams Journal of Surgery, 16, 3, 2023, 225-234. doi: 10.21608/asjs.2023.309406
HARVARD
Soliman, M., Elsabbagh, M., Elshimy, W., Salem, A. (2023). 'Effectiveness of Secondary Interventions to Rescue Threatened Distal Bypasses for Limb Salvage', Ain Shams Journal of Surgery, 16(3), pp. 225-234. doi: 10.21608/asjs.2023.309406
VANCOUVER
Soliman, M., Elsabbagh, M., Elshimy, W., Salem, A. Effectiveness of Secondary Interventions to Rescue Threatened Distal Bypasses for Limb Salvage. Ain Shams Journal of Surgery, 2023; 16(3): 225-234. doi: 10.21608/asjs.2023.309406
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