Mid- and long-term outcomes of extra-anatomic bypass procedures

Abstract

Objectives: In this study, we report our midand long-term results of extra-anatomic bypass surgery. Patients and methods: Between January 2005 and December 2011, a total of 65 patients (54 males, 11 females; mean age: 54.3±4.2 years; range, 20 to 82 years) with extra-anatomic bypass surgery with complete follow-up data were retrospectively analyzed. Extra-anatomic bypass surgery was performed to the lower extremity in 36 (55.3%) and the upper extremity in 29 (44.7%) patients. Additional distal bypass surgery was done in 18 of 36 patients with lower extremity disease. Results: The median follow-up time was 3.6 years (range, 3 months to 6 years). There was no early mortality, while there were five reoperations due to graft thrombosis and two amputations due to insufficient arterial f low in the postoperative period. There were two reoperations due to graft thrombosis and graft infection as late morbidity. In the long-term, the mortality rate was 6% (n=4) related to the malignancy in two patients, pulmonary embolism in one patient, and aortoduodenal fistula in one patient. Conclusion: An extra-anatomic bypass procedure is a surgical approach that can still be performed with low mortality and morbidity rates and acceptable patency rates in high-risk patients.