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Optimal Conduit Choice for Open Lower Extremity Bypass in Chronic Limb-threatening Ischemia by Jones P. Thomas; Kristine L. So; Jason T. Turner; Alexander J. Malanowski; Benjamin D. Colvard is a Medicine article available to read on EtoBox.

What is Optimal Conduit Choice for Open Lower Extremity Bypass in Chronic Limb-threatening Ischemia about?

a r t i c l e i n f o a b s t r a c t Open bypass surgery remains a major tool for limb salvage in chronic limb-threatening ischemia (CLTI). Although rest pain and tissue loss both fall into the category of CLTI, goals of revascularization are markedly different for each context. Rest pain mandates long-term patency considerations. Tissue loss, however, requires consideration of infection risks and patency enough to heal the wound. Of the major conduit options, autologous saphenous vein graft continues to be the conduit of choice, given both superior patency and low risk of infection. When saphenous vein graft is not available or not available in appropriate length, arm vein, small saphenous vein, and spliced combinations of these have acceptable patency rates. Heparin-bonded polytetrafluoroethylene and Dacron grafts are prosthetic conduits with excellent patency rates when vein is not available. For infected wounds without other options, cryovein continues to provide acceptable patency for limb salvage. Creation of a bypass is only part of CLTI management. Appropriate postoperative surveillance with noninvasive studies, including ankle-brachial index and duplex ultrasound, can ale

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Author

Jones P. Thomas; Kristine L. So; Jason T. Turner; Alexander J. Malanowski; Benjamin D. Colvard

Publisher

Elsevier BV

Published

2022

Language

EN

Field

Medicine (Health Sciences)