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3 . 2026

Preventive surgical interventions in patients after femorotibial bypass grafting

Abstract

Background. Patients with prolonged atherosclerotic occlusion of the femoropopliteal arterial segment, suffering from critical lower limb ischemia are candidates for femorotibial bypass. The primary patency of femorotibial bypasses is 43–55% over three years. Most often, graft thrombosis occurs within the first year.

Objective. To improve the patency of femorotibial bypasses in patients with chronic critical limb ischemia.

Patients and methods. From 2019 to 2022, a total of 45 patients underwent femorotibial bypass. They were divided into 2 groups: the first group included patients who regularly underwent preventive examinations in the postoperative period. When hemodynamically significant stenoses of the inflow, outflow, anastomoses or the graft itself were detected, patients underwent preventive surgical intervention aimed at correcting the pathology. The patients of the second group either did not show up for preventive examinations, or refused the surgical intervention with the revealed pathology of the reconstruction zones. The follow-up period was 2 years.

Results. Technical success after the first operation was achieved in all cases. The primary patency rate within two years in patients of group I was 59%, and in patients of group II – 56% (p=0.38). Primary-assisted patency rate was 80% in patients of group I and it was significantly higher than primary patency in group II (p=0.05). The limb salvage rate was 87% and 72% and was closely correlated with the survival rate amounting to 87% and 76%, respectively in patients of group I and II.

Conclusion. In the postoperative period, patients who have undergone femorotibial bypass need regular preventive examinations with ultrasound duplex scanning of the arteries of the operated limb. Preventive interventions after femorotibial bypass yield good immediate and medium-term results and reduce the frequency of amputations.

Keywords:prolonged arterial occlusion; tibial arteries; critical limb ischemia; femorotibial bypass; preventive surgical intervention

Authors’ contribution. Study conception and design – Zatevakhin I.I., Mustafin A.Kh., Frantsevich A.M.; data collection and handling – Bogomazov I.Yu., Omelchuk A.M; draft manuscript preparation – Mustafin A.Kh., Frantsevich A.M.; manuscript revision – Zolkin V.N.

For citation: Zatevakhin I.I., Mustafin A.Kh., Zolkin V.N., Frantsevich A.M., Bogomazov I.Yu., Omelchuk A.M. Preventive surgical interventions in patients after femorotibial bypass grafting. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2026; 32 (3): 87–92. DOI: https://doi.org/10.33029/1027-6661-2026-32-3-87-92

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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