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Bypass Surgery in Limb Salvage: Inflow Procedures

Authors:

Jean Bismuth ,

Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, US
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M.D.
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Cassidy Duran

Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, US
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M.D.
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Abstract

Proper management of lower-extremity inflow vessel disease is critical to the success of distal interventions. Aortobifemoral bypass is the most effective means of treating aortoiliac disease, but this invasive procedure is not always ideal for a patient population that often has diffuse vascular disease and multiple comorbidities. Technologic advances and increasing experience have fundamentally altered the management algorithm for lower-extremity vascular lesions, and endovascular options have become the first-line therapy for Trans-Atlantic Inter-Society Guidelines (TASC) class A and B lesions. In fact, an endovascular first approach is being endorsed even for highly complex TASC C and even TASC D lesions. Other alternatives include minimally invasive (laparoscopic or robotic) options or extra-anatomic bypass procedures. Inadequate outflow can compromise any inflow procedure, but inflow treatment failures are the crux of all limb salvage in patients with lower-extremity vascular disease.

How to Cite: 1. Bismuth J, Duran C. Bypass Surgery in Limb Salvage: Inflow Procedures. Methodist DeBakey Cardiovascular Journal. 2013;9(2):66-68. DOI: http://doi.org/10.14797/mdcj-9-2-66
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Published on 01 Apr 2013.
Peer Reviewed

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