Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
https://doi.org/10.21518/1995-1477-2022-19-1-44-49
Abstract
Introduction. For revascularization in the absence of autovenous material, epoxy-treated bioprostheses from the bovine internal mammary artery are widely used in the Russian Federation, which are subjected to certain structural deformations.
Purpose and objectives. To compare the structural changes of the biological prosthesis and autovenes in the long-term period after surgery and to determine the influence of some clinical and laboratory parameters on this process.
Materials and methods. The study included 45 patients with isolated occlusion of the superficial femoral artery (PBA), who underwent blood flow restoration using various types of prostheses. The patients were divided into 2 groups: group 1 (main) – 25 patients who underwent femoral-popliteal proximal bypass surgery with epoxy-treated bioprostheses from the bovine internal mammary artery; group 2 (control) – 20 patients who underwent femoral-popliteal proximal bypass surgery with a reversed autovena.
Results and discussion. During the follow – up period from 1 year to 8 years, 28% of bioprostheses underwent expansion, and 20.0% of patients with autovena showed narrowing of the shunt. In the main group, males had better biological graft patency (RR = 0.76 CI (0.3 2; 1.77)), but in the control group, the male sex increased the risk of occlusion (RR = 1.25 CI (0.18; 8.77)). When followed up for 5 years, the relative risk of prosthetic expansion decreased. At the same time, in patients of the control group, which is not characterized by ectasia, we revealed a decrease in the relative risk of stenosis. The clinical factor affecting the expansion of the biological prosthesis was type 2 diabetes mellitus.
Conclusions. The characteristic structural changes in the separated period (more than a year) for an autovenous conduit are narrowing, and for a biological prosthesis – expansion with the formation of aneurysms.
About the Authors
N. G. Khorev
Altai State Medical University; Clinical Hospital “Russian Railways-Medicine” of the City of Barnaul; City Hospital No. 5
Russian Federation
Russian Federation
Nikolai G. Khorev, Dr. Sci. (Med.), Professor, Head of the Department of Cardiology and Cardiovascular Surgery; Cardiovascular Surgeon of the Department of Vascular Surgery; Cardiovascular Surgeon of the Department of Vascular Surgery
40, Lenin Ave., Barnaul, Altai Territory, 656038; 20, Molodezhnaya St., Barnaul, Altai Territory, 656038; 75, Zmeinogorsky Tract, Barnaul, Altai Territory, 656045
V. I. Kotov
Clinical Hospital “Russian Railways-Medicine” of the City of Barnaul
Russian Federation
Russian Federation
Vladislav I. Kotov, Cardiovascular Surgeon of the Department of Vascular Surgery
20, Molodezhnaya St., Barnaul, Altai Territory, 656038
V. O. Konkova
Altai State Medical University; City Hospital No. 5
Russian Federation
Russian Federation
Viktoriya O. Konkova, Postgraduate Student of the Department of Faculty Surgery named after I.I. Neymark with a Course of Surgery of Additional Professional Education; Cardiovascular Surgeon of the Department of Vascular Surgery
40, Lenin Ave., Barnaul, Altai Territory, 656038; 75, Zmeinogorsky Tract, Barnaul, Altai Territory, 656045
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For citations:
Khorev N.G., Kotov V.I., Konkova V.O. Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2022;19(1):44-49. (In Russ.) https://doi.org/10.21518/1995-1477-2022-19-1-44-49
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