Document Type

Article

Publication Date

8-19-2022

Comments

This article is the author's final published version in Annals of Vascular Surgery - Brief Reports and Innovations, Volume 2, Issue 3, September 2022, Article number 100120.

The published version is available at https://doi.org/10.1016/j.avsurg.2022.100120. Copyright © 2022 The Authors. Published by Elsevier Inc.

Abstract

Objectives

Endovascular procedures for lower extremity revascularization are becoming more commonplace due to low morbidity, mortality, and shorter length of stay. The role of open bypass must be reconsidered. Aortobifemoral bypass is the gold standard for extensive aortoiliac occlusive disease (AIOD); however, thoracodistal bypass holds a niche position. We investigate indications and outcomes of thoracodistal bypass.

Methods

Medical records of five patients who underwent thoracodistal bypass at Thomas Jefferson University Hospital (TJUH) between 2012 and 2019 were reviewed. Contemporary and historical literature was reviewed.

Results

Indications included calcified paravisceral pathology, previous failed or infected bypass grafts, and prior abdominal operations. Thirty-day mortality at our institution was 0%. Four out of five patients had patent grafts at one year. Complications included pulmonary, renal, bleeding, and wound complications in addition to need for reintervention.

Conclusions

Despite high complication rates associated with thoracodistal bypass, longterm patency and longterm survival rates are also high. Thoracodistal bypass continues to be a useful tool in select patients.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English

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