An Axillary-Popliteal Artery Bypass Using PROPATEN^® for Critical Limb Ischemia Due to an Extremely Long Chronic Total Occlusion: A Case Report

Soichiro Fukushima, Naoki Toya, Kota Shukuzawa, Tadashi Akiba, Yuji Kanaoka and Takao Ohki

Department of Vascular Surgery, Jikei University Kashiwa Hospital, Japan
Department of Surgery, Jikei University Kashiwa Hospital, Japan
Department of Vascular Surgery, Jikei University School of Medicine, Japan

^*Correspondance to: Soichiro Fukushima 

 PDF  Full Text DOI: 10.25107/2474-1647.1252

Abstract

Background: Extra-anatomic bypass is a less invasive treatment option of surgical revascularization for high risk critical limb ischemia (CLI), but it is thought to be difficult to keep the patency for longer term. We experienced a CLI case due to an extremely long chronic total occlusion extending from the infrarenal abdominal aorta to the superficial femoral artery, and succeeded limb salvage by an axillary-popliteal artery bypass using a PROPATEN®, heparin bonded ePTFE graft, with double antiplatelet therapy. A long extra-anatomic bypass has low patency rate for longer term, but we can maintain the patency over 20 months without any target lesion revascularization. We report a rare case with some literatures.Case
Presentation: An 83 years-old man complained of rest leg pain, and he was diagnosed as CLI due to a long chronic total occlusion extending from the infrarenal abdominal aorta to the superficial femoral artery. Because he had received several times of surgeries for cancers, and also he had poor vein graft conditions, we selected an extra-anatomic bypass using a PROPATEN®. We succeeded limb salvage, and are able to keep the patency without any target lesion revascularization over 20 months.
Conclusion: An extremely long axillary-popliteal bypass using a PROPATEN® is not a gold standard treatment for CLI, but it may be one of an alternative option only for high risk patient.

Keywords

CLI; Surgical revascularization; Aortic occlusive disease; Axillary-popliteal artery bypass; PROPATEN®

Cite the article

Fukushima S, Toya N, Shukuzawa K, Akiba T, Kanaoka Y, Ohki T. An Axillary-Popliteal Artery Bypass Using PROPATEN^® for Critical Limb Ischemia Due to an Extremely Long Chronic Total Occlusion: A Case Report. Clin Surg. 2016; 1: 1253.