### Patient Initials or Identifier Number Mrs. L ### Relevant Clinical History and Physical Exam The 77-year-old female had the past history of DM for 16 years, hypertension for 30 years, chronic kidney disease stage 3, CAD s/p CABG, and left superficial femoral artery chronic total occlusion The Aorta-Femoral Bypass Graft Surgery is a procedure where the aorta is connected to the femoral artery with a prosthetic material (graft). Beijk and R.E. This bypasses the blood vessel that is damaged. The feet may be placed in sterile transparent bags to check for restoration of circulation. If lysis of the original bypass is not considered an option, which is better—redo bypass or attempts at endovascular recanalization of the native system? Arteries carry oxygen and nutrients to the body. unilateral femoral artery bypass, axillary-bilateral femoral bypass and bilateral axillary-femoral artery bypass [1]. with either axillofemoral or axillopopliteal bypass operations. Peripheral artery bypass is surgery to reroute the blood supply around a blocked artery in one of your legs. A bypass procedure is the commonest open surgical procedure carried out in the lower limb for ischaemia.   With the help of a natural or synthetic graft, a surgical Femoral popliteal bypass is the surgical opening of the upper leg to directly visualize the femoral artery. The authors report on a diabetic patient with tissue loss, previously treated with a femoral-tibial bypass, which occluded shortly after construction. Outcomes of native superficial femoral artery chronic total occlusion recanalization after failed femoropopliteal bypass. The goal of this study was to evaluate the early and midterm results of total arterial CABG with the descending branch of the lateral femoral The artery may become blocked with plaque, which is a buildup of fat. This artery delivers blood to your legs. When the femoral artery reaches the back of the knee it becomes the popliteal artery. Surgeries include: Aortobifemoral bypass.Femoropopliteal (fem-pop) bypass..Femoral-tibial bypass.Endarterectomy. Electronic address: [email protected] Impact of Adjunct Femoral Patch Reconstruction on Graft Patency after Below the Knee Popliteal Bypass Implantation Terézia B Andrási 1,2, Elke Dorner 1,2, Christof Kindler 2, Dieter Zenker 1, Christian F Vahl 2 and Friedrich A. Schöndube 1 The reconstruction of the three branches was also successfully completed. This retrospective study examined the outcomes of native superficial femoral artery (SFA) chronic total occlusion (CTO) recanalization compared with redo bypass after failed femoropopliteal bypass. Peripheral artery bypass is surgery to reroute the blood supply around a blocked artery in one of your legs.Fatty deposits can build up inside the arteries and block them. A femoral-tibial bypass will require a hospital stay. Femoral popliteal bypass. Femorofemoral (femoral-femoral) bypass is a method of surgical revascularization used in the setting of unilateral common and/or external iliac artery occlusive disease.The technique is dependent upon a patent iliac arterial system without hemodynamically significant disease to supply adequate inflow of blood to both lower extremities. In some cases, epidural anesthesia is also administered. Introduction Axillofemoral bypass is a method of surgical revascularization used in the setting of symptomatic aortoiliac occlusive disease for patients without an endovascular option or who cannot undergo an aortofemoral reconstruction. The technique was utilized for (1) preoperative circulatory support in the presence of florid heart failure or shock; (2) circulatory Objectives: The effect of superficial femoral artery (SFA) occlusion on long-term patency of aortofemoral bypasses (AFBs) for aortoiliac occlusive disease (AIOD) was examined. Its patency rate is generally not superior to that of intra-anatomical abdominal aorto-bifemoral bypass, but it can play important roles in conditions such as a hostile ab-domen and infectious abdominal aortic aneurysms [2– 4]. A femoral artery blockage can also cause pain in the calf when walking. Aortobifemoral bypass is the best option for a blockage that restricts blood flow to the femoral artery. Femoropopliteal bypass grafts are to the popliteal artery, either just above or just below the knee. Often, when people have narrowing in one of the superficial arteries in the leg, there are blockages elsewhere in the leg and in the body. addition to a bypass graft or balloon angioplasty. No peripheral vessels damage occurred, and no compartment fasciotomy or amputation needed. For blocked arteries in the thigh or lower leg - Femoropopliteal and femorotibial bypass grafts. How to fight bypass failure. for coronary artery bypass grafting (CABG), avoiding remote cardiac events associated with graft failure and improving the quality and expectancy of life in patients with coronary artery disease. The type of surgery used to treat PAD will depend on the size and location of the affected leg artery or arteries. An aorto-bifemoral or aorto-femoral bypass involves dissection of the common femoral arteries in the groin, followed by a laparotomy, dissection to the abdominal aorta, and then clamping of the artery below the renal arteries. ‘Atherosclerosis’ is the major reason for femoral artery blockage. Methods: The AIOD database was reviewed to identify risk factors for AFB failure. Femoral popliteal (also called femoropopliteal or Fem-Pop) bypass surgery is a procedure used to treat femoral artery disease. ABSTRACT Femoral vein-to-artery partial and total cardiopulmonary bypass was employed in 117 patients. The femoral artery is in the upper part of the leg. When there is a blockage in this artery, the circulation of blood to your leg is reduced which may cause pain in your calf when you walk, and is known as intermittent claudication. (a) The STA trunk and branch are exposed and dissected free with their surrounding cuff of tissue. Overview of Procedure. The left atrial to femoral artery bypass strategy was first described in 1962 by Dennis and was initially used in patients who could not be weaned from car-diopulmonary bypass after surgery.48-50 A dedicated system with a compact centrifugal pump (i.e., Tan-demHeart pVAD) was developed to allow rapid percutaneous institution of left atrial to femoral artery bypass (Fig. For some patients, a physician may recommend a procedure called a femoral-popliteal bypass, which uses a piece of a different blood vessel to help bypass the blocked portion of the femoral artery. What is Femoral Popliteal Bypass. Davies MG(1), El-Sayed HF(2). If the blockage is in the arteries in the pelvis, the bypass needs to run from the aorta in the abdomen to the femoral arteries in the groin. 3. Harskamp. Now that you know the location of femoral artery and its relevance with leg, let us know what causes femoral artery blockage. 36.2 Steps in performing the initial exposure for a superficial temporal artery–middle cerebral artery (STA–MCA) bypass. and Bypass Robert L. Berger, M.D., Virender K. Saini, M.D., and Everett L. Dargan, M.D. Blood vessels, or vein grafts, used for the bypass procedure may be pieces of a vein taken from the legs. BY DR. JEAN E. STARR IN THE LEG, also called lower extremity bypass, leg bypass, fem-pop bypass, fem-tib bypass, fem-distal bypass. It is the main artery that carries blood to the leg. Fig. Aortofemoral bypass surgery (also called aorto-BI-femoral bypass surgery) is used to bypass diseased large blood vessels in the abdomen and groin. Cardiovascular Report Winter 2011. Both groins & legs are prepared & draped. 36-1). Before conversion to thoracic aor- ta-to-femoral artery bypass, these 12 patients tin- derwent repair of one axillary anastomotic dehis- cence, removal of one infected axillofemoral graft, graft thrombectomy 11 times, and revision of … Cardiovascular Report - How to fight bypass failure. The operation's preoperative planning was based on an angiography obtained during the percutaneous procedure. artery-to-left subclavian artery bypass and femoral artery-to-innominate artery bypass were all completed at room temperature, with continuous selective bilateral cerebral perfusion. The femoral artery starts in the lower abdomen and runs down into the thigh. Treatment of heart failure or dysrhthmias may be required. Submitted: July 10th 2012 Reviewed: November 7th 2012 Published: March 13th 2013. Treatment of Coronary Artery Bypass Graft Failure. Femoral artery bypass. Fatty deposits can build up inside the arteries and block them 1).. Angiogram demonstrated a dissection flap occluding the deep femoral artery flow, which was unable to be crossed from an antegrade approach. (b) The temporalis muscle is divided and retracted anteriorly or in a T-shaped/cruciate fashion, maintaining the STA in continuity. Risks of femoral-tibial bypass include bleeding, infection, graft failure, swelling, heart attack, or stroke. Bypass surgery redirects blood through a grafted blood vessel. By M.A. For the iliofemoral approach this can be achieved through a low midline incision and the clamp applied to the common iliac artery. Peripheral arterial disease happens when there is a narrowing of the blood vessels outside of your heart 2).The cause of PAD is atherosclerosis. Femoral popliteal bypass is a procedure to go around (bypass) a blocked artery in the leg. IN THE ABDOMEN, also called aortic bypass, aorto-iliac bypass, aorto-femoral bypass, fem-fem bypass, aorto-mesenteric, and ax-fem bypass, depending on which blood vessel is being bypassed. One patient died for the sepsis and the subsequent multi organ failure 28 days postoperative. In these cases, there is a developed superior femoral artery that provides in-line flow to the distal leg. These are bypass grafts from the femoral artery at the groin to arteries further down the leg. A graft is used to replace or bypass the blocked part of the artery. Incision. It is performed under general anesthesia. Date: February 28, 2011. It is performed to bypass the blocked portion of the artery using a piece of another blood vessel. Author information: (1)Division of Vascular and Endovascular Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Tex. It is performed to bypass the blocked portion of main artery in the leg using a piece of another blood vessel. In a retrospective review of 199 operations, 24 factors influencing outcome were selected by stepwise logistic regression analysis, a sophisticated, multifactorial computer program. This study was carried out to determine whether we could develop a model to identify predictive factors for success of femoral-popliteal (FP) bypass grafts. Femoral artery blockage is considered to be a peripheral artery disease. In this case, a femoral-to-popliteal venous bypass procedure was performed subsequent to failure of a percutaneous procedure. The precise name given to the procedure depends on where the bypass starts and finishes, (ie, aorto-femoral, ilio-femoral, femoro-popliteal, femoro-tibial and popliteal-pedal bypass). A combination of antegrade contralateral femoral and retrograde tibial access was used for revascularization. Two patients received femoral-femoral artery bypass immediately after surgery because of the thrombosis in the right common iliac artery, without further injury. 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