Noriyuki Miyama1, Hiroyoshi Komai1,2,3, Takashi Nakamura4, Masahiro Iwahashi5,6, Nobuhiko Mukobara7, Masato Yoshida7, Hironobu Fujimura8, Takaki Sugimoto9, Hidenori Asada10, Nobuhiro Tanimura11,12, Takashi Azami13, Masatoshi Kawata14, Yoshihiko Tsuji15, Noboru Wakita16, Hitoshi Ogino2, Shunya Shindo3, Atsutoshi Hatada6, Takanori Oka12. 1. Department of Vascular Surgery, Kansai Medical University Medical Center, Moriguchi, Japan. 2. Department of Cardiovascular Surgery, Tokyo Medical University, Tokyo, Japan. 3. Department of Cardiovascular Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Japan. 4. Department of Vascular Surgery, Osaka Rosai Hospital, Sakai, Japan. 5. Department of Cardiovascular Surgery, National Hospital Organization Wakayama Hospital, Wakayama, Japan. 6. Department of Cardiovascular Surgery, Saiseikai Wakayama Hospital, Wakayama, Japan. 7. Department of Cardiovascular Surgery, Hyogo Brain and Heart Center, Himeji, Japan. 8. Department of Cardiovascular Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan. 9. Department of Cardiovascular Surgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan. 10. Department of Vascular Surgery, Kyoto Medical Center, Kyoto, Japan. 11. Department of Vascular Surgery, Soryukai Inoue Hospital, Suita, Japan. 12. Department of Cardiovascular Surgery, Takatsuki General Hospital, Takatsuki, Japan. 13. Department of Cardiovascular Surgery, Yodogawa Christian Hospital, Osaka, Japan. 14. Department of Cardiovascular Surgery, Saiseikai Suita Hospital, Suita, Japan. 15. Department of Surgery, Shinsuma General Hospital, Kobe, Japan. 16. Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan.
Abstract
Objective: The aim of this study was to elucidate the long-term results of crossover bypass (CB) for iliac atherosclerotic lesions in the era of endovascular treatment (EVT). Methods: A retrospective multicenter cohort study was performed. CB was performed in 242 patients between 2003 and 2014 by vascular surgeons at multiple medical centers in Japan. Results: Perioperative mortality was 1.7%. Primary patency rates were 86% at 5 years and 82% at 8 years. Univariate analysis showed that critical limb ischemia (Rutherford class 4-6), vein graft, and superficial femoral artery occlusion were significantly associated with low primary patency. In multivariate analysis, only critical limb ischemia influenced primary patency. The secondary patency rate was 87% at both 5 and 8 years. The limb salvage rate was 98% at both 5 and 8 years. The overall survival rates were 71% at 5 years and 49% at 8 years. Conclusion: The long-term results of CB were good in our study, compared with previous reports. Our results suggest that CB remains an option for the arterial reconstruction in unilateral iliac occlusive disease after EVT failed.
Objective: The aim of this study was to elucidate the long-term results of crossover bypass (CB) for iliac atherosclerotic lesions in the era of endovascular treatment (EVT). Methods: A retrospective multicenter cohort study was performed. CB was performed in 242 patients between 2003 and 2014 by vascular surgeons at multiple medical centers in Japan. Results: Perioperative mortality was 1.7%. Primary patency rates were 86% at 5 years and 82% at 8 years. Univariate analysis showed that critical limb ischemia (Rutherford class 4-6), vein graft, and superficial femoral artery occlusion were significantly associated with low primary patency. In multivariate analysis, only critical limb ischemia influenced primary patency. The secondary patency rate was 87% at both 5 and 8 years. The limb salvage rate was 98% at both 5 and 8 years. The overall survival rates were 71% at 5 years and 49% at 8 years. Conclusion: The long-term results of CB were good in our study, compared with previous reports. Our results suggest that CB remains an option for the arterial reconstruction in unilateral iliac occlusive disease after EVT failed.
Authors: J S Lindholt; K Houlind; B Gottschalksen; C N Pedersen; H Ravn; B Viddal; G Pedersen; M Rasmussen; C Wedel; M B Bramsen Journal: Br J Surg Date: 2016-08-01 Impact factor: 6.939
Authors: Sebastian Sixt; Hans Krankenberg; Charlotte Möhrle; Mathias Kaspar; Thilo Tübler; Aljoscha Rastan; Klaus Brechtel; Roland Macharzina; Franz-Josef Neumann; Thomas Zeller Journal: J Endovasc Ther Date: 2013-02 Impact factor: 3.487