P1-Bypass: Ist die autologe Vene noch indiziert? – Pro

Zusammenfassung

In der endovaskulären Ära wird die Indikation zur supragenualen Bypassanlage bei Patientinnen und Patienten mit längerstreckigen Pathologien der A. femoralis superficialis insgesamt nur mehr selten gestellt. Wenn die Entscheidung zur chirurgischen Sanierung des Gefäßproblems gefallen ist, muss die Wahl des Bypassmaterials getroffen werden. In diesem Artikel soll die Evidenz für die femoropopliteale Bypassanlage oberhalb des Knies (P1-Bypass) mittels autologer Vene dargestellt und ein klares Pro für den Venenbypass ausgesprochen werden.

Abstract

Nowadays endovascular treatment of pathologies of the superficial femoral artery is widely used and often the treatment of first choice. In patients with long-segment artery occlusions, bypass surgery can still be necessary. If so, the decision for adequate bypass material needs to be made. This manuscript summarises the available evidence on autogenous vein bypasses above the knee and presents a clear pro for venous grafts in the suprapopliteal segment.

Schlüsselwörter

periphere arterielle Verschlusserkrankung - Bypass-Chirurgie - Bypassmaterial

Key words

peripheral arterial disease - bypass surgery - bypass material

Publication History

Article published online:
07 October 2020

• Literatur

• 1 Klinkert P, Post PN, Breslau PJ. et al. Saphenous vein versus PTFE for above-knee femoropopliteal bypass. A review of the literature. Eur J Vasc Endovasc Surg 2004; 27: 357-362
• 2 Johnson WC, Lee KK. A comparative evaluation of polytetrafluoroethylene, umbilical vein, and saphenous vein bypass grafts for femoral-popliteal above-knee revascularization: a prospective randomized Department of Veterans Affairs cooperative study. J Vasc Surg 2000; 32: 268-277
• 3 Stonebridge PA, Prescott RJ, Ruckley CV. Randomized trial comparing infrainguinal polytetrafluoroethylene bypass grafting with and without vein interposition cuff at the distal anastomosis. The Joint Vascular Research Group. J Vasc Surg 1997; 26: 543-550
• 4 Abbott WM, Green RM, Matsumoto T. et al. Prosthetic above-knee femoropopliteal bypass grafting: results of a multicenter randomized prospective trial. Above-Knee Femoropopliteal Study Group. J Vasc Surg 1997; 25: 19-28
• 5 Aboyans V, Ricco JB, Bartelink MEL. et al. Editorʼs Choice – 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018; 55: 305-368
• 6 Conte MS, Pomposelli FB, Clair DG. et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg 2015; 61: 2S-41S
• 7 Gerhard-Herman MD, Gornik HL, Barrett C. et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135: e686-e725
• 8 [Anonymous] Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery (The Dutch Bypass Oral Anticoagulants or Aspirin Study): a randomised trial. Lancet 2000; 355: 346-351
• 9 Klinkert P, Schepers A, Burger DH. et al. Vein versus polytetrafluoroethylene in above-knee femoropopliteal bypass grafting: five-year results of a randomized controlled trial. J Vasc Surg 2003; 37: 149-155