Thromboendarterectomy combined with femoropopliteal bypass
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Abstract
Most complications that appear within 5–6 weeks after femoropopliteal bypass (FPB) are associated with the surgical procedure in the groin. Destruction of lymphatic structures in the presence of an open foot infection and crushing of the intima by clamping the common and deep femoral arteries are significant predisposing factors in producing early infection or occlusion of the graft. To avoid these predisposing factors, a combined procedure of a short thromboendarterectomy of the proximal superficial femoral artery and an autogenous or prosthetic bypass graft was used, without application of clamps to the common and deep femoral arteris. In a series of 45 patients, this combined procedure was used and a significant reduction of complications was achieved. Indications, technique, and advantages of this combined method are discussed.
Keywords
Femoral Artery Bypass Graft Early Infection Combine Method Superficial Femoral ArteryRésumé
La majorité des complications qui surviennent au cours des 5–6 semaines qui suivent un bypass fémoro-poplité résultent de la dissection au niveau de l'aine. La destruction des lymphatiques en cas d'infection du pied et l'écrasement de l'intima par clampage des artères fémorales commune et profonde sont d'importants facteurs qui prédisposent à l'infection précoce et à l'occlusion du greffon. Pour éviter ces traumatismes, nous utilisons une thromboendartériectomie courte de la fémorale superficielle proximale, associée à un bypass par prothèse ou veine, sans clampage des artères fémorales commune ni profonde. Cette intervention a été utilisée dans 45 cas: la fréquence des complications a été nettement réduite. Les indications, la technique et les avantages de la méthode sont discutés.
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