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Thorac Cardiovasc Surg 2016; 64(04): 311-315
DOI: 10.1055/s-0035-1560039
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Crural Bypass for Critical Lower Limb Ischemia with Omniflow II Prosthesis

Friedrich Dünschede
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, Germany
,
Justina Stabrauskaite
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, Germany
,
Gerhard Weisser
2   Department of Medicine 2, University Hospital Mainz, Medical Center, Mainz, Germany
,
Christine Espinola-Klein
2   Department of Medicine 2, University Hospital Mainz, Medical Center, Mainz, Germany
,
Bernhard Dorweiler
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, Germany
,
Christian-Friedrich Vahl
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz, Mainz, Germany
› Author Affiliations
Further Information

Publication History

04 February 2015

26 June 2015

Publication Date:
20 August 2015 (online)

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Abstract

Background Reports about the use of the Omniflow II prosthesis (Bio Nova International, Victoria, Australia) in a crural position in patients with critical lower limb ischemia are rare.

Methods All crural bypass operations were registered in a database. Primary end points of the study were amputation-free survival, limb salvage, and long-term patency.

Results From January 2007 to December 2012, we implanted 27 Omniflow II prostheses in the crural position for critical lower limb ischemia. Of these, 12 crural bypasses were conducted with adjuvant distal arteriovenous fistula as a means to increase bypass flow in the presence of severely impaired intraoperative runoff or revision for early failure. Fifteen Omniflow II prosthesis bypasses were performed in the crural position without fistula. Overall, two patients died postoperatively. The limb salvage rate was 92% in the fistula group compared with 60% in the nonfistula group after a median observation time of 19 months in patients getting Omniflow prosthesis bypasses.

Conclusion Omniflow II prosthesis in patients with critical lower limb ischemia and absence of sufficient autologous vein is durable. Moreover, the use of adjuvant distal arteriovenous fistula may increase the chance of limb salvage in this group of patients.

Keywords

atherosclerosis - peripheral vascular disease (outside the chest) - shunts
 

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