Our Summary

This research paper is about a study involving 60 patients who had severe blood flow problems in their legs due to clogged arteries. The patients were divided into two groups. The first group received a traditional treatment, which involved making a detour around the clogged artery using one of their own veins. The second group received a new type of treatment, which also used one of their own veins but didn’t require reversing it.

This new treatment turned out to be more effective. It increased blood flow in the leg by 1.5 times, improved artery blood flow by 1.6 times, and boosted the rate of microcirculation (the circulation of blood in the smallest blood vessels) by 1.3 times. It also reduced early post-surgery complications by 23.4% and the risk of late blood clotting in the vein graft by 40%.

Moreover, the new treatment improved the long-term success of the vein graft by 2.6 times. It also had a positive impact on patients’ health, improving their physical health by 10.6% and their mental health by 4.3%.

Two years after the surgery, the vein graft was still working in 36.7% of patients in the traditional treatment group and 83.3% of patients in the new treatment group. The leg was saved in 60% of the first group and 90% of patients in the second group.

FAQs

  1. What is the difference between the traditional autovenous bypass and the original technology that was used for the second group of patients?
  2. What were the benefits of using the original treatment technology for femoral-popliteal bypass?
  3. What were the long-term results for patients in both the first and second group after two years since the operation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about femoral-popliteal bypass is to follow postoperative care instructions carefully, including keeping the surgical site clean and dry, taking prescribed medications as directed, and attending follow-up appointments to monitor the success of the procedure. It is also important to maintain a healthy lifestyle, including quitting smoking, eating a balanced diet, and exercising regularly to improve overall circulation and reduce the risk of future complications.

Suitable For

Patients with critical ischemia of the lower extremities due to atherosclerotic lesions of the femoral-popliteal-tibia segment are typically recommended femoral-popliteal bypass surgery. This procedure may be recommended for patients who have not responded to conservative treatments such as medications or lifestyle changes, and who are at risk of limb loss or other serious complications. Patients who have severe blockages in the arteries of the lower extremities, leading to decreased blood flow and tissue damage, may benefit from femoral-popliteal bypass surgery to improve blood flow and prevent further damage to the affected limb.

Timeline

  • Before femoral-popliteal bypass surgery:
  1. Patient presents with critical ischemia of the lower extremities due to atherosclerotic lesions of the femoral-popliteal-tibia segment.
  2. Complex examination is conducted to assess the severity of the condition and determine the best course of treatment.
  3. Traditional autovenous bypass surgery using the reverse big saphenous vein is performed for the first group of patients.
  4. Original technology using a free autovenous transplant with collapsed valves without vein reverse is used for the second group of patients.
  5. Blood flow volume, arterial blood flow, and microcirculation are measured to evaluate the effectiveness of the surgery.
  6. Postoperative complications and shunt thrombosis rates are monitored in the early and late stages.
  • After femoral-popliteal bypass surgery:
  1. Blood flow volume in the extremity increases by 1.5 times, arterial blood flow by 1.6 times, and microcirculation by 1.3 times in the second group of patients.
  2. Early postoperative complications are reduced by 23.4% and late shunt thrombosis by 40% in the second group.
  3. Long-term shunt passability improves by 2.6 times, and the physical and psychological components of health show improvement in the second group.
  4. Two years post-operation, the shunt functions in 83.3% of patients in the second group compared to 36.7% in the first group.
  5. The extremity is saved in 90% of patients in the second group compared to 60% in the first group.

What to Ask Your Doctor

  1. What is the success rate of femoral-popliteal bypass surgery for patients with critical ischemia of the lower extremities?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period after femoral-popliteal bypass surgery?
  4. What lifestyle changes or medications may be necessary following the surgery to prevent future blockages?
  5. How often will follow-up appointments be needed to monitor the success of the surgery?
  6. Are there any alternative treatment options to consider besides femoral-popliteal bypass surgery?
  7. What are the expected outcomes in terms of increased blood flow volume, arterial blood flow, and microcirculation after the surgery?
  8. How long can the patient expect the bypass graft to function effectively?
  9. How will the patient’s overall quality of life be impacted by the surgery and recovery process?
  10. Are there any specific factors or conditions that may affect the success of femoral-popliteal bypass surgery for the patient?

Reference

Authors: Sykovatykh BS, Belikov LN, Sykovatykh MB, Sidorov DV, Inarkhov MA, Inikhodova EB. Journal: Vestn Khir Im I I Grek. 2016;175(4):75-9. PMID: 30457277