Lower Extremity Bypass

Treatment Options for Lower Extremity Bypass and Arterial Trauma

Clinical Results:

  • Enhanced graft anastomotic compliance due to vessel elasticity
  • Reduced risk of infection
  • Excellent long-term patency outcomes with a five-year overall primary patency rate of 66.7% and 74.6% secondary patency rate

Lower Extremity Bypass Using Bovine Carotid Artery Graft (Artegraft): An analysis of 124 Cases with Long-Term Results
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F. Bechara, Peter H. Lin
World Journal of Surgery, Published online: 17 August 2017
DOI:10.1007/s00268-017-4161-x

A total of 124 BCAG (Artegraft, North Brunswick, NJ) were implanted in 120 patients for lower extremity revascularization. Surgical indications included disabling claudication in 12%, rest pain in 36%, tissue loss in 48%, and infected prosthetic graft replacement in 3%. Autologous saphenous vein was either inadequate or absent in 72% of patients. BCAG was used in 46 patients (37%) who had a prior failed ipsilateral leg bypass. Distal anastomosis was performed in the above-knee popliteal artery, below-knee popliteal artery, and tibial artery in 30 cases (25%), 32 cases (26%), and 48 cases (39%), respectively. Distal anastomotic patch was created in all tibial artery to allow BCAG-tibial reconstruction. The yearly primary patency rates in 5 years were 86.5, 76.4, 72.2, 68.3, and 67.5%, respectively. The corresponding yearly secondary patency rates were 88.5, 84.7, 82.4, 78.5, and 75.6%, respectively. The limb salvage rate at one year was 83.6% and at five years was 86.2% for patients with critical limb ischemia.