Soichiro Fukushima1*, Naoki Toya1, Kota Shukuzawa1, Tadashi Akiba2, Yuji Kanaoka3 and Takao Ohki3
1Department of Vascular Surgery, Jikei University Kashiwa Hospital, Japan
2Department of Surgery, Jikei University Kashiwa Hospital, Japan
3Department of Vascular Surgery, Jikei University School of Medicine, Japan
Background: Extra-anatomic bypass is a less invasive treatment option of surgical revascularization for high risk critical limb ischemia (CLI), but it is thought to be difficult to keep the patency for longer term. We experienced a CLI case due to an extremely long chronic total occlusion extending from the infrarenal abdominal aorta to the superficial femoral artery, and succeeded limb salvage by an axillary-popliteal artery bypass using a PROPATEN®, heparin bonded ePTFE graft, with double antiplatelet therapy. A long extra-anatomic bypass has low patency rate for longer term, but we can maintain the patency over 20 months without any target lesion revascularization. We report a rare case with some literatures.Case
Presentation: An 83 years-old man complained of rest leg pain, and he was diagnosed as CLI due to a long chronic total occlusion extending from the infrarenal abdominal aorta to the superficial femoral artery. Because he had received several times of surgeries for cancers, and also he had poor vein graft conditions, we selected an extra-anatomic bypass using a PROPATEN®. We succeeded limb salvage, and are able to keep the patency without any target lesion revascularization over 20 months.
Conclusion: An extremely long axillary-popliteal bypass using a PROPATEN® is not a gold standard treatment for CLI, but it may be one of an alternative option only for high risk patient.
CLI; Surgical revascularization; Aortic occlusive disease; Axillary-popliteal artery bypass; PROPATEN®
Fukushima S, Toya N, Shukuzawa K, Akiba T, Kanaoka Y, Ohki T. An Axillary-Popliteal Artery Bypass Using PROPATEN® for Critical Limb Ischemia Due to an Extremely Long Chronic Total Occlusion: A Case Report. Clin Surg. 2016; 1: 1253.