Relevant bibliographies by topics / Bypass graft

Academic literature on the topic 'Bypass graft'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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Journal articles on the topic "Bypass graft"

Davidovic, Lazar, Ilija Kuzmanovic, Dusan Kostic, Ilijas Cinara, Slobodan Cvetkovic, Miljko Ristic, Dusan Velimirovic, and Dragica Jadranin. "Obturator or "lateral" bypass in the management of infected vascular prostheses at the groin." Srpski arhiv za celokupno lekarstvo 130, no. 1-2 (2002): 27–32. http://dx.doi.org/10.2298/sarh0202027d.

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The infection of the previously implanted vascular graft at the groin, is associated with great mortality and morbidity rate [1]. The authors present a retrospective study in which they analyzed management of infected vascular prostheses at the groin, using obturator bypass in 26 cases, and "lateral" bypass in 15 cases. The indications for obturator bypass reconstructions included: 20 infections of aorto-femoral grafts, two infected pse udoaneurysms in the groin after RTA of the superficial femoral artery, and 4 infections of iliac-femoral grafts. The indications for lateral bypass reconstructions were: infections after aorto-femoral reconstructions - 8 cases; infection after femora-popliteal reconstructions - 4 cases; infection after iliac-femoral reconstruction - 2 patients, and one infected pseudoaneurysm in the groin after RTA of the superficial femoral artery. In 3 subjects obturator bypass was performed using extraperitoneal approach while in other 23 patients transperitoneal approach was done by donor's artery. The obturator bypass was performed using a PTFE graft in 3 cases and Dacron graft in 23. The donor's artery used for obturator bypass was a noninfected proximal part of aortofemoral graft in 20 cases, and iliac artery in 6 patients. The superfical femoral artery was recipient artery for obturator bypass in 3 cases, deep femoral artery in one case, and above the knee popliteal artery in 22 cases (Figure 1). In two patients transperitoenal approach to donors artery for "lateral" bypass has been used, and in 13 cases extraperitoneal. The proximal noninfected part of aorto femoral graft was used as a donor's artery for lateral bypass in 8 patients, while common iliac artery in 7 subjects. In 5 cases recon structions were performed using PTFE grafts, in 3 using autologous saphenous vein grafts, and in 7 using Dacron grafts. The recipient artery for "lateral" bypass was deep femoral in 8 cases, superficial femoral in three patients and above the knee popliteal artery in 4 subjects. After both types of reconstruction, extirpation of infected grafts from the groin was performed (Figure 2). The control examination was performed using physical and Doppler ultrasonographic examinations, one, 3, 6, 12 months, and then every year after the operation. In cases with suspected graft infection or thrombosis, control angography was also performed. One intraoperative perforation of the urinary bladder has been done accidentally during obturator bypass reconstruction. The mean follow-up period for patients with obturator bypasses was 2.3 years, while 2.1 years for patients with "lateral" bypasses. Comparing with "lateral" bypass, obturator bypass showed statistically significant lower (p < 0.05) 30- day mortality and early graft infection rate, as well as statistically significant better early and total limb salvage rate. There were no statistically significant differences (p > 0.05) between obturator and "lateral" bypass procedures having in mind, late graft infection rate, as well as early and late graft patency (Figures 3 and 4). In cases with infected vascular prostheses in the groin, the authors recommend obturator bypass comparing with "lateral" bypass.

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Januszewski, Jacob, Jeffrey S. Beecher, David J. Chalif, and Amir R. Dehdashti. "Flow-based evaluation of cerebral revascularization using near-infrared indocyanine green videoangiography." Neurosurgical Focus 36, no. 2 (February 2014): E14. http://dx.doi.org/10.3171/2013.12.focus13473.

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Object Indocyanine green (ICG) videoangiography has been established as a noninvasive technique to gauge the patency of a bypass graft; however, intraoperative graft patency may not always correlate with graft flow. Altered flow through the bypass graft may directly cause delayed graft occlusion. Here, the authors report on 3 types of flow that were observed through cerebral revascularization procedures. Methods Between February 2009 and September 2013, 48 bypass procedures were performed. Excluded from analysis were those cases in which ICG videoangiography was not performed during surgery (whether it was not available or there was a technical issue with the microscope or the quality of ICG angiography) and/or in which angiography or CT angiography was not done within 24–72 hours after surgery. After anastomosis, bypass patency was assessed first using a noninvasive technique and then with ICG videoangiography, and flow through the graft was characterized. Patients who received a vein or radial artery graft were also evaluated with intraoperative angiography. Results Thirty-three patients eligible for analysis were retrospectively analyzed. The patients had undergone extracranial-intracranial (EC-IC) or IC-IC bypass for ischemic stroke (13 patients), moyamoya disease (10 patients), and complex aneurysms (10 patients; 6 giant or large aneurysms, 2 carotid blister-like aneurysms, and 2 dissecting posterior inferior cerebellar artery [PICA] aneurysms). Thirty-six bypasses were performed including 26 superficial temporal artery (STA)–middle cerebral artery (MCA) bypasses (2 bilateral and 1 double-barrel), 6 EC-IC vein grafts, 1 EC-IC radial artery graft, 1 PICA-PICA bypass, 1 MCA–posterior cerebral artery bypass, and 1 occipital artery–PICA bypass. Robust anterograde flow (Type I) was noted in 31 grafts (86%). Delayed but patent graft enhancement and anterograde flow (Type II) was observed in 4 cases (11%); 1 of these cases with an EC-IC vein graft degraded gradually to very delayed flow with no continuity to the bypass site (Type III). Additionally, 1 STA-MCA bypass graft revealed no convincing flow (Type III). The 5 patients with Type II or III grafts were evaluated with a flow probe and reexploration of the bypass site, and in all cases the reason the graft became occluded was believed to be recipient-vessel competitive flow. In no case was there evidence of stenosis or a technical issue at the site of the anastomosis. Three patients with Type II and the 1 patient with Type III flow (11% of procedures) did not have a patent bypass on postoperative imaging. Conclusions Indocyanine green videoangiography is reliable for evaluating flow through the EC-IC or IC-IC bypass. The type of flow observed through the graft has a direct relationship with postoperative imaging findings. Despite the possibility of competitive flow, Type III and some Type II flows through the graft indicate the need for graft evaluation and anastomosis exploration.

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Solaković, Emir, Dragan Totić, and Sid Solaković. "Femoro-Popliteal Bypass Above Knee with Saphenous Vein vs Synthetic Graft." Bosnian Journal of Basic Medical Sciences 8, no. 4 (November 20, 2008): 367–72. http://dx.doi.org/10.17305/bjbms.2008.2899.

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There is still debate whether sintethic graft (polytetrafluoroethylene or Dacron) is equivalent to vein as bypass graft material for the above-knee femoropopliteal bypass. Therefore, we performed prospective randomized trial to compare vein with polytetrafluoroethylene/dacron for femoropopliteal bypasses with the distal anastomosis above the knee. Between January 2000 and June 2003, 121 femoropopliteal bypasses were performed. The indications for operation were severe claudication in 96 cases, rest pain in 16 cases, and ulceration in 9 cases. After randomization, 60 reversed saphenous venous bypasses and 61 polytetrafluoroethylene/ dacron bypasses were performed. No perioperative mortality was seen, and 5% of the patients had minor infections of the wound, not resulting in loss of the bypass, the limb, or life. After 5 years, 37% of the patients had died and 7% were lost to follow-up. Only once saphenous vein was necessary for coronary artery bypass grafting. Primary patency rates after 5 years were 76,6% for venous bypass grafts and 59,1% for polytetrafluoroethylene/dacron grafts (p=0,035). Secondary patency rates were 83,3% for vein and 69,2% for polytetrafluoroethylene/dacron bypasses (p = 0,036). In the venous group, 10 bypasses failed, leading to four new bypasses. In the polytetrafluoroethylene group, 22 bypasses failed, leading to 12 reinterventions. After 5 years of follow-up, we conclude that a bypass with saphenous vein has better patency rates at all intervals and needs fewer reoperations. Saphenous vein should be the graft material of choice for above-knee femoropopliteal bypasses and should not be preserved for reinterventions. Polytetrafluoroethylene/dacron is an acceptable alternative if the saphenous vein is not available.

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Ramanathan, Dinesh, Nancy Temkin, Louis J. Kim, Basavaraj Ghodke, and Laligam N. Sekhar. "Cerebral Bypasses for Complex Aneurysms and Tumors." Neurosurgery 70, no. 6 (March 6, 2012): 1442–57. http://dx.doi.org/10.1227/neu.0b013e31824c046f.

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Abstract BACKGROUND: Various techniques of cerebral bypasses are used to treat aneurysms and tumors. OBJECTIVE: To study long-term clinical and radiological outcome of various bypass types and to analyze techniques used in the management of long-term graft problems. METHODS: A consecutive series of patients who underwent revascularization during a 5-year period were analyzed for indications, graft patency, and neurological outcomes. Potential risk factors for bypass problems and the management of bypass stenosis were studied. RESULTS: A total of 80 patients (69 with aneurysms and 11 with tumors) underwent 88 bypasses (59 extracranial-to-intracranial [EC-IC] bypasses [10 low flow, 49 high flow], 9 intracranial-to-intracranial [IC-IC] bypasses [3 long, 6 short], and 20 local bypasses), with mean radiological follow-up of 32 months (range, 1–53 months). At late follow-up, 5 of 9 (56%) IC-IC (5 short, 0 long grafts), 8 of 9 (90%) EC-IC low-flow, 44 of 48 (92%) EC-IC high-flow, and all local bypasses were patent. Four patients with EC-IC high-flow bypass occlusions were asymptomatic, but transient ischemic attacks were noted in 3 of 6 patients with graft stenosis. None of the risk factors evaluated were significantly predictive of EC-IC graft occlusions or stenosis. EC-IC HF graft stenoses were permanently corrected by microsurgery (n = 4) or endovascular surgery (n = 1). CONCLUSION: The EC-IC and local bypasses have higher long-term patency rates (91% and 100%) compared with IC-IC bypasses (66%, 0% long graft). Some EC-IC bypasses may occlude asymptomatically (9%) or develop graft stenosis (13%) over the long term. Microsurgical and endovascular surgical techniques have been developed to treat graft stenosis.

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Khandanpour, Nader, Felicity J. Meyer, Lily Choy, Jane Skinner, and Matthew P. Armon. "Are femorodistal bypass grafts for acute limb ischemia worthwhile?" Jornal Vascular Brasileiro 8, no. 4 (December 2009): 294–300. http://dx.doi.org/10.1590/s1677-54492009000400003.

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Background: It has been shown that autogenous veins are associated with the best limb salvage rates for femorodistal bypass surgery. However, in emergency settings, when an autogenous vein is unavailable, use of synthetic graft material or amputation is a critical decision to make. Objective: To assess the appropriateness of femorodistal bypass grafts for acute limb ischemia in emergency settings. Methods: Patients who underwent emergent bypass and elective femorodistal bypass surgery between 1996 and 2006 were reviewed retrospectively in a single center. Results: There were 147 patients of which 84 had elective and 63 had emergent bypass. The graft patency rates for elective admissions were 44 and 25% vs. 25 and 23% for admissions for acute femorodistal graft surgery at 2 and 4 years, respectively (p < 0.004). Admissions for acute ischemia who were treated with prosthetic grafts had a primary patency of 24 vs. 27% for vein grafts at 2 years and 24 vs. 23% at 4 years (p = 0.33). In the acute femorodistal grafts group, primary patency at 2 years for vein and prosthetic grafts was 27 and 24% as compared to 42 and 32% for electives. These values for cumulative limb salvage rates for elective bypasses were 73 and 63% as compared to 52% at both time points in the acute femorodistal graft group (p < 0.004). In emergency settings, the limb salvage rate for acute femorodistal bypass with prosthetic grafts was 38%, and for vein grafts it was 62% at both time points (p = 0.08). Conclusion: The long term limb salvage rate of 38% suggests that emergent femorodistal revascularization is worthwhile.

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Mohit, Alex A., Laligam N. Sekhar, Sabareesh K. Natarajan, Gavin W. Britz, and Basavaraj Ghodke. "High-flow Bypass Grafts in the Management of Complex Intracranial Aneurysms." Operative Neurosurgery 60, suppl_2 (February 1, 2007): ONS—105—ONS—123. http://dx.doi.org/10.1227/01.neu.0000249243.25429.ee.

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Abstract THE MAJORITY OF intracranial aneurysms can be treated by either endovascular coiling or microsurgical clipping. A small group of aneurysms may require vascular bypass or reconstruction for their management. A variety of vascular reconstruction techniques are available, including direct suture, patch grafting, local reimplantations, side to side anastomosis, and bypass grafts. Bypass grafts may include low-flow (superficial temporal to middle cerebral) and high-flow bypass grafts using either the radial artery or saphenous vein. In this article, the indications and techniques of high-flow bypasses and concurrent aneurysm management are discussed. Troubleshooting of these bypasses is also illustrated. Seven intraoperative videos have been provided to demonstrate the various techniques of radial artery graft harvesting, cervical exposure of carotid vessels, bypasses, and concurrent aneurysm management.

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Alcocer, Francisco, William D. Jordan, Douglas J. Wirthlin, and David Whitley. "Early Results of Lower Extremity Infrageniculate Revascularization with a New Polytetrafluoroethylene Graft." Vascular 12, no. 5 (September 2004): 318–24. http://dx.doi.org/10.1258/rsmvasc.12.5.318.

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When an autologous vein is not available for lower extremity revascularization, prosthetic grafts are often required. However, prosthetic bypass grafts have limited patency for infrageniculate reconstruction. To potentially improve patency, a new geometric modification of the polytetrafluoroethylene (PTFE) graft, Distaflo (Impra, Tempe, AZ), has been developed for lower extremity bypass. We reviewed our early experience with the Distaflo graft in patients who required infrageniculate bypass for lower extremity ischemia when no suitable autologous saphenous vein was available. All patients were maintained on warfarin anticoagulation postoperatively. All grafts were followed at 6- to 12-week intervals with duplex ultrasound evaluation. Patient characteristics, operative procedures, and graft surveillance information were maintained on a computerized registry. Thirty-two patients with limb-threatening ischemia underwent 35 infrageniculate reconstructions with a Distaflo graft between February 26, 1999, and August 24, 2000. Thirty-two of 35 bypasses were performed on extremities that had previously undergone a surgical procedure. Forty-eight previous revascularization procedures were done on these 25 extremities. Thirty grafts were constructed to the tibial outflow sites, whereas the remaining five grafts were placed to the below-knee popliteal artery. One patient died on the second postoperative day secondary to unrelated causes, and only one graft (3%) failed during the same hospitalization. Fifteen of 35 grafts (43%) remained patent 1 to 30 months later. Four patent grafts (6%) were ligated between 2 and 14 months for infectious indications. When considering the 20 failed grafts, 9 patients underwent major amputation, 5 patients remain with chronically ischemic limbs, and 6 patients underwent additional bypass grafts. Twenty-three patients (72%) maintained limb salvage. The Distaflo PTFE graft achieves promising early patency for complex infrageniculate revascularization and may be used as an alternative conduit in patients with critical limb ischemia who do not have an adequate vein for lower extremity revascularization.

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Neufang, Achim, Carolina Vargas-Gomez, Patrick Ewald, Nicolaos Vitolianos, Tolga Coskun, Nael Abu-Salim, Rainer Schmiedel, Peter von Flotow, and Savvas Savvidis. "Very distal vein bypass in patients with thromboangiitis obliterans." Vasa 46, no. 4 (June 1, 2017): 304–9. http://dx.doi.org/10.1024/0301-1526/a000624.

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Abstract. Background: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. Patients and methods: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking. Angiography was able to identify a suitable distal arterial segment for the bypass which was revascularized by means of an autologous vein graft. Grafts were followed with repetitive duplex ultrasound. Revision of the bypass graft was initiated if indicated by pathological duplex findings. Results: In all cases a bypass could be constructed with either the ipsilateral greater saphenous vein or arm veins. A distal origin configuration was possible in three cases with popliteo-pedal or cruro-pedal bypasses. In the fourth case the distal superficial femoral artery was used for inflow. Two early graft thromboses underwent successful revision. During follow-up, duplex ultrasound identified graft stenoses in three bypasses which were successfully treated with endovascular techniques. All grafts are patent with complete resolution of ischaemic symptoms after 46, 42, 32, and 29 months. The patients remained non-smokers and returned to a professional life. Conclusions: Surgical therapy with distal vein bypass for persistent ischaemic symptoms after definitive cessation of smoking seems feasible in selected cases with TAO and a suitable distal artery. Close follow-ups of the patients with duplex ultrasound are necessary to identify developing vein graft stenoses. Angioplasty seems to be an important part of the long-term therapeutic concept.

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Kawashima, Masatou, Albert L. Rhoton, Necmettin Tanriover, Arthur J. Ulm, Alexandre Yasuda, and Kiyotaka Fujii. "Microsurgical anatomy of cerebral revascularization. Part I: Anterior circulation." Journal of Neurosurgery 102, no. 1 (January 2005): 116–31. http://dx.doi.org/10.3171/jns.2005.102.1.0116.

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Object. Revascularization is an important component of treatment for complex aneurysms that require parent vessel occlusion, skull base tumors that involve major vessels, and certain ischemic diseases. In this study, the authors examined the microsurgical anatomy of cerebral revascularization in the anterior circulation by demonstrating various procedures for bypass surgery. Methods. Twenty-five adult cadaveric specimens were studied, using 3 to 40 magnification, after the arteries and veins had been perfused with colored silicone. The microsurgical anatomy of cerebral revascularization in the anterior circulation was examined with the focus on the donor, recipient, and graft vessels. The techniques discussed in this paper include the superficial temporal artery (STA)—middle cerebral artery (MCA), middle meningeal artery (MMA)—MCA, and side-to-side anastomoses; short arterial and venous interposition grafting; and external carotid artery/internal carotid artery (ICA)—M2 and ICA—ICA bypasses. Bypass procedures for cerebral revascularization are divided into two categories depending on their flow volume: low-flow and high-flow bypasses. A low-flow bypass, such as the STA—MCA anastomosis, is used to cover a relatively small area, whereas a high-flow bypass, such as the ICA—ICA anastomosis, is used for larger areas. Cerebral revascularization techniques are also divided into two types depending on the graft materials: pedicled arterial grafts, such as STA and occipital artery grafts, and free venous or arterial grafts, which are usually saphenous vein and radial artery grafts. Pedicled arterial grafts are mainly used for low-flow bypasses, whereas venous or arterial grafts are used for high-flow bypasses. Conclusions. It is important to understand the methods of bypass procedures and to consider indications in which cerebral revascularization is needed.

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Chantelau. "Does oral anticoagulation improve femoropedal graft patency in diabetic patients? Lessons from the Dutch BOA Study." Vasa 30, Supplement 58 (November 1, 2001): 47–49. http://dx.doi.org/10.1024/0301-1526.30.s58.47.

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Graft patency rates after arterial reconstruction benefit from aspirin treatment. The Dutch Bypass Oral anticoagulant or Aspirin (BOA) Study, a randomized controlled trial, compared the use of oral anticoagulants (e.g. phenprocoumon) versus aspirin in a large sample of patients after infrainguinal arterial bypass surgery. Graft occlusion was the primary endpoint. A total of 2650 bypasses were performed, 531 of which were femorocrural or femoropedal grafts. Of the latter, 194 (37%) were carried out in the subgroup of 700 diabetic patients (i.e. 26% of the total study population). There was no significant difference in patency rates of these particular grafts with either drug. Hence, aspirin 100 mg/day is as effective as oral anticoagulation to benefit patency rates in femorocrural and femoropedal bypass grafts, irrespective of the diabetic status of the patients. Aspirin is sufficient, and oral anticoagulation is not required for this particular type of reconstruction.

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Dissertations / Theses on the topic "Bypass graft"

Felden, Luc. "Mechanical optimization of vascular bypass grafts." Thesis, Available online, Georgia Institute of Technology, 2005, 2005. http://etd.gatech.edu/theses/available/etd-04112005-145422/unrestricted/felden%5Fluc%5F200505%5Fmast.pdf.

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Thesis (M. S.)--Mechanical Engineering, Georgia Institute of Technology, 2005.
David N. Ku, Committee Chair ; Alexander Rachev, Committee Co-Chair ; Elliot L. Chaikof, Committee Member. Includes bibliographical references.

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Tellmann, Gudrun. "Untersuchungen zur Pathogenese der "Bypass graft disease"." [S.l.] : [s.n.], 2001. http://ArchiMeD.uni-mainz.de/pub/2002/0040/diss.pdf.

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Al-Ruzzeh, Sharif Mohamed Hasan Khalaf. "Outcome of coronary artery bypass graft surgery with and without cardio-pulmonary bypass." Thesis, Imperial College London, 2003. http://hdl.handle.net/10044/1/8394.

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Rowe, Christopher Stuart. "Improving the local haemodynamics of bypass graft anastomoses." Thesis, University of Liverpool, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367237.

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Riedel, Bernard J. C. J. "Epidural analgesia for coronary artery bypass graft surgery." Master's thesis, University of Cape Town, 1999. http://hdl.handle.net/11427/25890.

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On reviewing the medical literature, there is a clear resurgence of interest in the use of TEA (thoracic epidural analgesic) in cardiac anaesthesia. This resurgence was brought about by laboratory-based evidence that TEA-induced sympatholysis may be cardioprotective through the promotion of myocardial blood flow to areas at-risk and subsequent early, small clinical studies suggesting that TEA was feasible, and possibly also beneficial in CABG surgery [Joachimsson et. al, 1989; Liem (1-3) et. al, 1992; Stenseth et. al, 1994]. Despite the positive results of these early studies and suggestions that TEA may be the preferred anaesthetic/analgesic technique in select groups of patients (promoting early extubation and fast-tracking) undergoing cardiac surgery, many anaesthetists are still reluctant, however, to use this technique because of the theoretical increased risk of the patient suffering a spinal haematoma and subsequent paraplegia. In order to outweigh this theoretical risk it is important that we show that added benefit, in addition to the provision of analgesia and expedited postoperative convalescence, can be obtained by using TEA. It is therefore our duty as anaesthetists and perioperative physicians to determine whether TEA may also affect the pathophysiology of the disease process, especially in the perioperative period - and thereby influencing the subsequent long term outcome and quality of life of the patient. An example of this latter point would be the potential role of TEA in; • reducing the incidence of perioperative myocardial infarction (P-MI), through the suggested cardioprotective effects of TEA, • reducing the incidence of early postoperative graft failure, through either; * reduction of native coronary artery and/or graft (conduit) spasm, or * reduction of postoperative hypercoagulability.

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Poon, Chui-yuk Mabel. "The patients lived experiences after coronary artery bypass graft surgery /." View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B31596071.

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MacGinley, Robert. "Granulation tissue as a vascular graft /." [St. Lucia, Qld.], 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16819.pdf.

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Okrainec, Karen. "Cardiac medical therapy following coronary artery bypass graft surgery." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=80344.

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Despite the benefits of coronary artery bypass graft surgery (CABG), graft closure can still occur and lead to the development of unstable angina, myocardial infarction (MI) and death. Secondary prevention is thus greatly needed in order to prevent future cardiovascular events in the post-CABG patient. Few studies have examined the benefits of cardiac medical therapy specifically among CABG patients. A review of randomized controlled trials (RCT's) was first conducted in order to understand what constitutes appropriate cardiac medical therapy in the post-CABG patient.
The use of aspirin, clopidogrel, coumadin, anti-lipid agents, anti-ischemic medications (beta-blockers, CCB's, nitrates) and ACE inhibitors was then examined among patients enrolled in the Routine versus Selective Exercise Treadmill Testing After Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) Study. We examined the use of these medications among all patients as well as patients with various co-morbidities.

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Sarkar, S. "Development of a synthetic small calibre vascular bypass graft." Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1322995/.

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Polyurethanes are an attractive class of material for bioprosthesis development due to the ability to manipulate their elasticity and strength. However, their use as long term biological implants is hampered by biodegradation. A novel polyurethane has been developed which incorporates nano-engineered polyhedral oligomeric silsesquioxane within poly(carbonate-urea) urethane to improve the biostability of the latter. Previous investigators have found this material to be cytocompatible and to have low thrombogenicity. The medium and long term clinical results of currently available prosthetic small calibre vascular bypass grafts are poor, due to neo-intimal hyperplasia associated with their non-compliant properties. The investigation reported here commences with the benchtop manufacture of compliant small calibre grafts using an original extrusion- phase inversion technique. The reproducibility of the technique as well as the effect on the pore structure of different coagulation conditions is demonstrated. Fundamental mechanical characterisation of the grafts produced is then presented, by way of tensillometry to demonstrate the viscous and elastic properties of the material. These are made more relevant to the clinical setting with functional mechanical characterisation of the grafts, showing graft compliance in a biomimetic flow circuit along with viscoelastic hysteresis, along with burst pressure testing. An examination of burst pressure testing methodology is also shown, in the light of the various non-standardised strategies reported in the graft-testing literature. Mechanical characterisation shows the short-term safety for use, but durability studies in the biological haemodynamic environment serve to assess longer term fatigability as well as confirming biostability. This has been reported using a stringent ovine carotid interposition model which remained patent over the full investigation period representing at least 45 million pulsatile cycles. Physico-chemical analysis; integrity of the structure, microstructure and ultrastructure; preservation of mechanical properties and immunohistological analysis were used to examine the grafts after implantation to show their healing properties and biostability.

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Pettersson, Nils, and Gabriella Johnsson. "Riskfaktorer för postoperativa sårinfektioner efter Coronary Artery Bypass Graft." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-225259.

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Bakgrund: Postoperativa sårinfektioner [PSI] är en allvarlig komplikation och ett hälsoproblem som orsakar lidande för patienten. Såsom vid alla operativa ingrepp förekommer en risk att få PSI i operationssåret/-såren efter Coronary Artery Bypass Graft [CABG], men det finns redan en rad kända riskfaktorer som ökar risken för PSI. Syfte och metod: Syftet med rapporten var att undersöka om kombinationen av ett antal sedan tidigare kända riskfaktorer ökade risken för PSI efter CABG på ett mellansvenskt sjukhus åren 2009-2012. En retrospektiv journalgranskningsstudie med totalt 228 patienter genomfördes. Resultat: Av 228 undersökta hade totalt 50 patienter rapporterat sårinfektion och 73 patienter hade ≥ 3 riskfaktorer. Bland de som hade ≥ 3 riskfaktorer rapporterade 32,9% PSI och bland de som hade < 3 riskfaktorer rapporterade 16,8% PSI. Risken att få PSI efter CABG-kirurgi är nästan dubbelt så stor (RR=1,960) hos patienter med ≥ 3 riskfaktorer jämfört med patienter med < 3 riskfaktorer (X2=7,516 df=1 p=0,006). Slutsats: Det finns en signifikant högre risk för PSI efter CABG vid förekomst av tre eller fler än tre patientrelaterade riskfaktorer jämfört med färre än tre riskfaktorer. Fler, större studier av detta slag efterfrågas då denna rapport kan ge en fingervisning om hur situationen föreligger på ett mellansvenskt sjukhus.
Objective: Postoperative surgery site infections [SSI] is not only a severe complication but a health problem which often cause suffering and prolonged hospitalization among afflicted patients. As with all surgical procedures, a coronary artery bypass graft [CABG] always implicates a risk for SSI and a number of risk factors have to be taken into account when dealing with it. The objective of this report is to investigate if a combination of several patient-related risk factors implicates greater risk of getting SSI after CABG. Method: A quantitative retrospective journal review of 228 patients who completed a CABG between 2009-2012 was performed on a university hospital in central Sweden. Result: Among 228 patients a total of 50 reported SSI and 73 patients had ≥ 3 patient-related risk factors. Among those who had ≥ 3 risk factors 32.9% reported SSI and among those who had < 3 risk factors 16.8% reported SSI. The risk of getting SSI after CABG is almost twice as high (RR = 1.960) in patients with ≥ 3 risk factors compared to patients with < 3 risk factors (X2 = 7.516 df = 1 p = 0.006). Conclusion: There is a significantly higher risk of getting SSI after CABG in the presence of three or more than three patient-related risk factors, compared with fewer than three risk factors. More, larger studies of this kind are in demand since this report provides an indication of how the situation may prevail on a central Swedish university hospital.

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Books on the topic "Bypass graft"

Allanby, Charlotte. Patient perception of preoperative physiotherapy following coronary artery bypass graft. Northampton: Nene College, 1995.

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Allanby, Charlotte. Patient perception of preoperative physiotherapy following coronary artery bypass graft. Northampton: NeneCollege, 1995.

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Saltmore, Susan Margaret. An evaluation of psychological interventions prior to coronary artery bypass graft surgery. Manchester: University of Manchester, 1997.

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MacMaster, Lesley Mary. Patients' pain management at the end of the first week after discharge following coronary artery bypass graft surgery. Ottawa: National Library of Canada, 2002.

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Bursey, Mary Elsie. Attitudes, subjective norm, perceived behavioural control, and intentions related to adult smoking cessation after coronary artery bypass graft surgery. Ottawa: National Library of Canada, 1996.

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Kunov, Mads J. Numerical simulation and visualization of blood flow in arterial bypass grafts. Ottawa: National Library of Canada = Bibliothèque nationale du Canada, 1993.

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Arterial grafting for myocardial revascularization: Indications, surgical techniques, and results. Berlin: Springer-Verlag, 1990.

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Aortic femoral bypass graft. Scarborough, ON: Scarborough General Hospital, 1992.

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R, Bates Eric, and Holmes David R. 1945-, eds. Saphenous vein bypass graft disease. New York: M. Dekker, 1998.

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Davierwala, Piroze M., and Friedrich W. Mohr. Coronary artery bypass graft surgery. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0048.

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The surgical management of acute coronary syndrome still remains a challenge for the cardiac surgeon. Although most patients can be managed by percutaneous coronary intervention, for patients with complex multivessel or left main coronary artery disease (high SYNTAX score), in whom percutaneous coronary intervention is not possible or is unsuccessful, urgent or emergent coronary artery bypass graft surgery is the only available option. It is very important for surgeons to determine the optimum timing of surgical intervention, which is usually based on the clinical presentation, coronary anatomy, and biomarkers. Surgeons should be conversant with the different operative techniques, whether off- or on-pump coronary artery bypass graft surgery, that would help in achieving the best possible outcomes in such situations. Early and late survival of patients depends not only on an efficiently executed operation, but also on the competency of the post-operative care delivered. Modern perioperative management is reinforced by the availability of a variety of mechanical cardiopulmonary assist devices, like the intra-aortic balloon pump, the extracorporeal membrane oxygenation, and an array of ventricular assist devices, which aid us in managing very sick patients presenting with cardiogenic shock. The results of coronary artery bypass graft surgery for acute coronary syndrome, as published in the literature, vary significantly, because of the heterogeneity of patient populations, operative timing, and haemodynamic status, making a comparison of surgical outcomes almost impossible. Only one randomized trial has been conducted to that effect, to date. A heart team approach, involving an interventional cardiologist and a cardiac surgeon, is mandatory to determine the best treatment strategy and achieve the best possible outcomes in patients with acute coronary syndrome.

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Book chapters on the topic "Bypass graft"

Uzieblo, Maciej. "Aortobifemoral bypass graft." In Endovascular and Open Vascular Reconstruction, 289–93. Boca Raton : CRC Press, 2017.: CRC Press, 2017. http://dx.doi.org/10.1201/9781315113845-44.

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Snooks, S. J., and R. F. M. Wood. "Aortobifemoral Bypass Graft." In Fundamental Anatomy for Operative General Surgery, 62–63. London: Springer London, 1989. http://dx.doi.org/10.1007/978-1-4471-1667-7_28.

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Suzuki, Tomoaki, and Tohru Asai. "Graft Planning." In Off-Pump Coronary Artery Bypass, 93–100. Tokyo: Springer Japan, 2016. http://dx.doi.org/10.1007/978-4-431-54986-4_12.

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Stadelmann, Mathieu, Diego Arroyo, and Serban Puricel. "Imaging of Coronary Bypass Graft." In Coronary Graft Failure, 477–82. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-26515-5_41.

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Kunz, Richard. "Coronary Artery Bypass Graft." In Encyclopedia of Clinical Neuropsychology, 964–65. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-57111-9_11.

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Hammond, Flora, and Lori Grafton. "Coronary Artery Bypass Graft." In Encyclopedia of Clinical Neuropsychology, 707. New York, NY: Springer New York, 2011. http://dx.doi.org/10.1007/978-0-387-79948-3_11.

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Kolkailah, Ahmed A., Fernando Ramirez Del Val, Tsuyoshi Kaneko, and Sary F. Aranki. "Coronary Artery Bypass Graft." In Contemporary Cardiology, 291–310. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-97622-8_14.

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Whyte, John, and Richard Kunz. "Coronary Artery Bypass Graft." In Encyclopedia of Clinical Neuropsychology, 1–2. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-56782-2_11-3.

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Kunz, Richard. "Coronary Artery Bypass Graft." In Encyclopedia of Clinical Neuropsychology, 1–2. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-56782-2_11-4.

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Pearce, William H., Walter J. McCarthy, William R. Flinn, and James S. T. Yao. "Composite sequential bypass graft." In Vascular Surgery, 341–44. Boston, MA: Springer US, 1994. http://dx.doi.org/10.1007/978-1-4899-6854-8_30.

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Conference papers on the topic "Bypass graft"

Graor, R., J. Young, B. Beven, N. Hertzer, L. Krajewski, P. O'Hara, J. Olin, and W. Ruschhaupt. "rt-PA THROMBOLYSIS VERSUS SURGICAL THROMBECTOMY OF PERIPHERAL BYPASS GRAFTS:A COMPARATIVE TRIAL." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643888.

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Twenty-nine of 33 patients (88%) with thrombosed lower extremity bypass grafts had angiographic and clinical successful lysis of graft thrombi with rt-PA. Of the successful group, 18 were saphenous vein grafts and 11 PTFE grafts in the femoropopliteal-tibial position. Following lysis, 76% required a secondary procedure (2 PTA, 20 surgical repair and 7 required anticoagulation) to maintain patency. A matched cohort of patients with bypass grafts who had surgical thrombectomy were compared to the rt-PA successfully treated grafts and analyzed for duration of patency after opening and limb salvage. The Kaplan-Meier curve compared both treatment groups and demonstrated improved graft survival in the rt-PA treated group (p=.01) (median graft survival rt-PA 195 days, surgery 30 days). Limb salvage was marginally significant (p=.064) in favor of the rt-PA treatment group. Single and multi-variant risk factor analysis found smoking and age of the graft adversely affected patency (p=.05 and p=.08 respectively). Graft type, age of the patient, diabetes mellitus, and high blood pressure were not significant factors (p> .15).Systemic fibrinolysis was identified to varying degrees. Mean decreases in the fibrinolytic constituents include: 59% decrease in clottable fibrinogen, 18% decrease in sulfite fibrinogen, 78% decrease in alpha-2 antiplasmin and varying degrees of increases in DDIMER, B-Beta1-42 and B-Beta15-42 coincident with the constituent changes. Complications were unrelated to constituent changes. One patient had major bleeding secondary to graft anastomosis disruption.Thrombolysis with rt-PA is an effective and more durable adjunct treatment option for thrombosed bypass grafts, especially when combined with PTA or surgical repairto maintain patency.

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Sankaran, Sethuraman, and Alison L. Marsden. "A Computational Technique for Robust Optimization of Cardiovascular Bypass Graft Surgeries." In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19095.

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Bypass graft (BG) surgeries involve surgical construction of a graft over a blocked blood vessel. The graft can either be native tissue of the patient or a synthetic material. Some commonly performed BG surgeries include aorto-bifemoral, femoro-popliteal, femoro-tibial, and coronary artery bypass (CABG). The operative mortality rate for CABG is around 3%. Around 15 to 30% of bypass grafts occlude within the first year of surgery, increasing to over 50% after 10 years. Graft incompatibility, and hemodynamic factors such as blood recirculation, low wall shear stress, and abnormal wall shear stress gradients play an important role in the onset and development of intimal thickening and plaque deposition (atherogenesis).

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Bernad, S. I., A. Bosioc, E. S. Bernad, I. Petre, and A. F. Totorean. "Flow characteristics in narrowed coronary bypass graft." In INTERNATIONAL CONFERENCE OF NUMERICAL ANALYSIS AND APPLIED MATHEMATICS 2015 (ICNAAM 2015). Author(s), 2016. http://dx.doi.org/10.1063/1.4951781.

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Dur, Onur, Sinan T. Coskun, Levent B. Kara, and Kerem Pekkan. "Improved Patient-Specific Coronary Artery Graft Configurations Using CFD Coupled Shape Optimizer." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206861.

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Bypass conduits provide an alternative route around critically blocked arteries. Current surgical anastomosis techniques and the design of synthetic coronary artery bypass grafts (CABG) frequently lead to post-surgical complications such as intimal thickening, restenosis and eventual long term graft failure. Pathological hemodynamic states are usually precursors of intimal hyperplasia or platelet deposition and result in graft occlusion. From fluid mechanics perspective, abnormalities in coronary flow include recirculation zones, low/oscillating shear stresses, vortices, and areas of stagnation within the CABG.

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Qiao, Aike, and Teruo Matsuzawa. "Hemodynamics of End-to-End Femoral Bypass Graft." In ASME/JSME 2004 Pressure Vessels and Piping Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/pvp2004-3125.

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In the conventional femoral bypassing operation, side-to-end (STE) configuration at the proximal anastomosis and end-to-side (ETS) configuration at the distal anastomosis are usually employed. With these configurations, blood flow from the bypass graft at the distal anastomosis strongly strikes on the floor of the host artery opposite the anastomosis. This will result in the violent variations of hemodynamics in the vicinity of distal anastomosis, and further bring about anastomotic intimal hyperplasia (IH) and restenosis. Consequently, the effectiveness of bypassing surgery is compromised in the medium and long term by the development of these pathological changes. It is widely accepted that hemodynamics is close correlated to the geometry configuration of femoral bypass graft. It is verified that flow field at the distal junction has more influences on the pathogenesis and its aftereffects are more critical because the development of IH and restenosis is prone to occur in that region and endangers the patency of subsequent arteries. Nonuniform hemodynamics, characterized by nonuniform Wall Shear Stress (WSS) and large sustained Wall Shear Stress Gradients (WSSG), is also commonly considered as one of the most important causes among the numerous complex physiological and biomechanical factors. Purpose of the present study is to investigate an alternative geometry configuration to improve the hemodynamics at the vicinity of distal anastomosis and increase the medium and long term patency rate of bypass graft surgery. According to the clinical observation, the stenosed host artery may become fully stenosed after bypassing surgery and the bypass graft is the only way to restore normal blood flow to ischemic limbs. The authors presented a modified bypassing configuration with an end-to-end (ETE) conjunction at the distal anastomosis. In this new model, the proximal graft is arc-shaped with STE junction and the distal graft is sinusoid-shaped with ETE junction. The bypass graft is of the same diameter of d = 8mm as the host femoral artery, so the graft can be connected with the femoral artery smoothly at the distal junction. The polytetrafluoroethylene (PTFE) is employed as the graft material. The blood is assumed to be an isotropic, homogeneous, incompressible, Newtonian continuum having a constant density and viscosity. The vessel walls are assumed to be rigid and impermeable. The blood flow is assumed to be physiologically pulsatile laminar flow. The mean Reynolds number is Rem = 204.7, Womersley number is α = 6.14. The boundary conditions include: the physiologically pulsatile entrance velocities at the inlet section, the no-slip boundary condition on the wall, the symmetric condition in the centerline plane of femoral and graft, and the outlet pressure condition with a reference pressure P = 0 at the exit section. Three-dimensional idealized femoral bypass graft model is developed and discretized. The blood flow in the proposed model is simulated with computational fluid dynamics (CFD) method using the finite element analysis. The temporal and spatial distributions of hemodynamics such as flow patterns and WSS in the vicinity of distal anastomosis during the cardiac cycle were analyzed. Especially, the emphasis here was on the analysis of WSS, the temporal and spatial WSSG and the Oscillating Shear Index (OSI). The simulation results indicated that: (1) the ETE model is featured with small secondary flow; (2) WSS at the distal anastomosis is uniform, WSSG is small, and OSI of the ETE model has not much changes compared with ETS graft. The present study showed that the femoral bypassing configuration with ETE bypass graft was of more favorable hemodynamics, and it could consequently improve the flow conditions and decrease the probability of IH and restenosis. With the consideration of that numerical simulation was proved to be of great help and guidance meaning for the biofluidmechanics research and the biomedical engineering, the results of the present study can be applied to medical device design and clinical treatment planning in addition to the application of computational methods to cardiovascular disease research.

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Bernad, Sandor I., and Elena S. Bernad. "Coronary Venous Bypass Graft Failure, Hemodynamic Parameters Investigation." In Biomedical Engineering. Calgary,AB,Canada: ACTAPRESS, 2012. http://dx.doi.org/10.2316/p.2012.764-161.

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Pandur, Sanko. "REVIEW UP-TO-DATE CORONARY ARTERY BYPASS GRAFT SURGERY." In Acquired Heart Diseases. Academy of Sciences and Arts of Bosnia and Herzegovina, 2015. http://dx.doi.org/10.5644/pi2015-158-08.

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Campbell, Triona, Reena Cole, and Michael O’Donnell. "Pressure Induced Strain at Femoral Artery Bypass Graft Junctions." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176342.

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Femoral or femoropopliteal artery bypass graft junctions have a predilection for failure due to restenosis. It has been clinically proven that vascular reconstructions tend to restenose within a short period of time [1]. Extensive studies have cited wall shear stresses as being primarily responsible and definite correlations between hydrodynamic stresses in the arterial wall and arterial disease have been shown [2,3]. However intensive investigations into wall shear stresses have lead to conflicting arguments on the proliferation and propagation of stenoses. It was concluded by Freidman [4] that the intima at sites exposed to relatively high or unidirectional shears thickened initially, but as time progressed the greatest thicknesses were ultimately achieved at sites exposed to lower or more oscillatory shear environments. A contradicting view was expressed by Nazemi [5] that low wall shear stress contributed to the onset of atherosclerotic plaque formation, whilst high wall shear stress encouraging plaque growth. A number of studies have however established a statistically significant correlation between pressure and intimal hyperplasia and concluded that blood pressure and not blood flow is the primary factor responsible for the localization of atherosclerosis [6–8].

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Ramachandra, Abhay B., Sethuraman Sankaran, Jay D. Humphrey, and Alison L. Marsden. "Growth and Remodeling of Vein Graft in an Arterial Environment: Parameter Estimation and Sensitivity Analysis." In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14617.

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In coronary artery disease, surgical revascularization using venous bypass grafts is performed to relieve symptoms and prolong life. Coronary bypass graft surgery is performed on approximately 500,000 people every year in the United States, with graft failure rates as high as 50% within 5 years. When a vein graft is implanted in the arterial system it adapts to the high flow rate and high pressure of the arterial environment by changing composition and geometry. Hemodynamics is known to play an active role in growth and remodeling of blood vessels but the complete underlying mechanism of vein graft failure is not well understood. Experiments required to understand this phenomenon can be resource and time intensive. In order to augment the existing knowledge and to guide design and interpretation of experiments that are needed to refine our understanding of vein graft growth and remodeling, computational models of vascular growth and remodeling are used to describe and predict the response of vein grafts to changes in hemodynamic loads. Computational models of growth and remodeling have numerous parameters, and even the inputs from experiments have uncertainties associated with them. There is therefore a need for a systematic approach to estimate the parameters included in growth and remodeling models and to evaluate sensitivity of the quantities of interest to parametric variations.

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Goldman, S., J. Copeland, T. Moritz, W. Henderson, and L. A. Harker. "EFFECT OF ANTIPLATELET THERAPY ON EARLY GRAFT PATENCY AFTER CORONARY ARTERY BYPASS GRAFTING: VA COOPERATIVE STUDY # 207." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643612.

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To determine if specific antiplatelet therapy improved graft patency after coronary artery bypass grafting (CABG) -we compared (1) aspirin(325 mg qd), (2)aspirin(325 mg tid),(3) aspirin and dipyridamole(325 mg and 75 mg resp.tid), (4) sulfinpyrazone(267 mg tid) and (5) placebo(tid).Therapy was started 48 hours before CABGexcept for aspirin. When aspirin was a treatment,one 325 mg dose was given12 hours before surgery. Graft patency data were obtained early, one week, and then later, one year, after surgery. Preliminarydata, based on local interpretation of the angiograms at each center, in the firs 496 patients (1711 grafts), revealed thefollowing early graft patencies: aspiri qd (93%), aspirin tid (93%), aspirin and dipyridamole (93%),and sulfinpyrazone (92%). All these therapies improved(P<0.005)early graft patency compared to placebo (84%). Chest tube drainage measured within the first 35 hours after CABG revealed that the median loss with aspirintid (1114 ml) and aspirin and dipyridamole (972 ml) exceeded (P<0.001) placebo (802 ml) while aspirinqd (880 ml) and sulfinpyrazone (750 ml) did not. The reoperation rate was greater(P<0.01) in all the treatment groups thatcontained aspirin (6.1%) compared to the two non aspirin groups (1.9%). Overall operative mortality was 2.1%. In conclusion, graft patency was improved early after CABG with antiplatelet therapy. Two regimens which included preoperative aspirin has increased blood loss after CABG and preoperative aspirin increased the reoperation rate.

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Reports on the topic "Bypass graft"

Armour, Sara C., James B. Goode, Collis H. Lang, Leas R. Tilley, John Craig, Bruce A. Schoneboom, and Doraline Watts. Effects of Dexmedotomidine in the Coronary Artery Bypass Graft (CABG) Patient: A Pilot Study. Fort Belvoir, VA: Defense Technical Information Center, April 2006. http://dx.doi.org/10.21236/ada446260.

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Danielson, Daren, Lucas P. Neff, Sterling Humphrey, and W. D. Boyd. Pilot Study of the Efficacy of Extracellular Matrix Arterio-Venous Bypass Grafts in a Sheep (Ovis aries) Model. Fort Belvoir, VA: Defense Technical Information Center, December 2013. http://dx.doi.org/10.21236/ada608131.

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