Vascular surgeries, peripheral bypass

Peripheral bypass surgeries are operations that generally involve leg vessels, except for the heart (arms, internal organs). Peripheral Vascular Disease (peripheral artery: arterial disease=PAH) is a term used for arterial occlusions involving these regions.

The basis of the disease is called atherosclerosis (calcification in the vein).

In such surgeries, the goal is to supply blood to the area fed by the occluded vessel with the bypass technique.

IN PERIPHERAL BYPASS SURGERY

WHAT ARE THE VESSELS USED?

The patient’s own vein (leg superficial vein) or a synthetic graft (artificial vein) is used for bypass.

Despite all the studies and technology today, artificial veins that can replace the natural artery have not been produced. Although artificial veins give good results in arterial regions with larger diameters (abdominal and inguinal veins), they are always disadvantageous in terms of occlusion and clot in the long term. In areas of smaller arteries, the results are not so good. In mandatory cases, PTFE type or dacron type artificial cores with the best results are used. Successful results have been obtained when PTFE type artificial veins are coated with a blood thinner called heparin.

The patient’s own vein (autologous vein), which can remain open for a long time, is the most suitable option. It is the first choice especially in leg bypass surgeries. This vein is used by removing it from the leg and reversing it for current. Long-term vitality and nutrition are effective on the open rate.

In the five-year follow-up results of above-knee bypasses, patency rates of autologous vein (the patient’s vein) were determined as 66-75% and synthetic grafts 50%. The patency rate is lower in below-knee bypasses.

In order of vessels to be used for bypass;

1. The patient’s own vein
2. Homologous grafts (with glutaraldehyde) made in human umbilical cord
3. PTFE
4. A sorting can be made in the form of Dacron grafts.

PERIPHERAL BYPASS SURGERY

1. Aorto-Femoral, Aortobifemoral (Bypass surgeries performed unilaterally or bilaterally from the intra-abdominal main aorta to the inguinal veins.
2. Femoro-Popliteal Bypass: Bypasses from the inguinal artery to the apical artery. LAPTOP BYPASS.
3. Femorotibial Bypass: Bypass made from the inguinal artery to one of the three arteries below the knee: UNDER KNEE BYPASS.

*Apart from these three classes, there are also bypass surgeries performed outside the normal anatomical region. It is used in cases where opening the abdomen may be problematic. Bypass is made either from the opposite groin or from the shoulder area with artificial veins.

With the increase in balloon and stent applications in recent years, endovascular interventions have taken the place of surgery in large vessels. Surgery is still a viable option for below-knee and thin veins.

Key

Bypass, peripheral bypass, serdar akgün, vascular occlusion, vascular surgeries, leg vascular occlusion, bypass, bypass surgeries