Extra anatomical bypass in peripheral arterial diseases

Extremity revascularization in peripheral artery diseases (PAD) can be applied with otogenous, biologic or synthetic grafts. Extraanatomic bypass can be applied in patient with PAD whom had concomitant disease (advanced cardiac, pulmonary or renal disease and cancer etc.) or situations that lead to impossible or high risk to classical approach. In this study we aimed to investigate the mortality and morbidity rates with possible reasons of extraanatomic bypass applied patients in our clinic in the view of literature. Fifteen patients who have extra anatomic bypass application history between July 2008 and February 2014 were evaluated retrospectively. Automation system of hospital was used to evaluation and follow up patient's data. Nine (60%) male, 6 (40%) female patients were included our study. Main age of patients was 66.26±14.67 (31-81). Revascularization was applied for upper extremity in 2 of patients (13%), for down limb in 13 of patients (87%). Carotid to brachial was applied in 1 case, subcliavian to carotid bypass was applied in 1 case according to upper extremity. Femoral to femoral was applied in 8 cases, axillar to iliac was applied in 1 case, axillary to bi-femoral was applied in 1 cases, obturatory bypass was applied in 1 case according to down limb. PTFE grafts were used for all patients. Early period mortality was observed into to one (6%) patients. Late mortality was not observed any of the patients. Embolectomy was applied in two (12%) patients early period. To sum up, extraanatomic bypass applications can be optional surgical procedure with acceptable mortality and morbidity rates in high risk patients. KEY WORDS: Peripheral artery disease, extraanaotmic bypass, clinical outcomes