Research Article

Cross-Sectional Autovenous Bypass - Reserve Reconstruction in Patients with High Risk of Amputation and Low Life Expectancy or an Alternative to Conventional Surgery in Chronic Limb Threatening Ischemia

Authors: Kuchay AA, Lipin AN, Gruzdev NN, Borisov AG, Atmatzas AV, Atmatzas KA.

DOI: 10.33425/3065-7059-1003

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Abstract

Purpose of the Study: To evaluate early (complications and major adverse events) and long-term (patency, limb salvage, survival) outcomes in patients with chronic limb threatening ischemia who underwent crossover autovenous bypass surgery.\r\n\r\nMaterials and Methods: A retrospective analysis of the early and long-term results of observation of 28 patients who underwent cross-bypass surgery performed in 2017-2023 was carried out. 100% of bypass operations were performed with autovenous material. High comorbidity (coronary artery disease, arterial hypertension, dyslipidemia, history of myocardial infarction, history of acute stroke, cardiac arrhythmias, diabetes mellitus, obstructive bronchitis, anemia, obesity). Follow-up is 12 months.\r\n\r\nResults: Early postoperative complications were: 14.3% - wound complications, 3.6% - bleeding, 7.2% - bypass thrombosis, 3.6% - acute cerebrovascular disturbance, 17.9% - high limb amputation (in 4 of 5 observations, revascularization was performed to reduce the level of amputation), 3.6% - death. Results after 12 months were: bypass patency – 82.1%, limb salvage – 71.4%, survival – 89.3%. There were no cases in which critical ischemia of the healthy lower limb developed.\r\n\r\nConclusion: Cross-sectional autovenous bypass can be considered by a vascular surgeon both as a backup option in repeated reconstructive interventions on lower limb arteries and as an alternative to traditional anatomic reconstructions. This study demonstrates the low complication rate and good long-term patency of such reconstructions.

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