Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery

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 o...

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Main Authors: N. G. Khorev, V. I. Kotov, V. O. Konkova
Format: Article
Language:Russian
Published: Remedium Group LTD 2022-05-01
Series:Амбулаторная хирургия
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Online Access:https://www.a-surgeon.ru/jour/article/view/280
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author N. G. Khorev
V. I. Kotov
V. O. Konkova
author_facet N. G. Khorev
V. I. Kotov
V. O. Konkova
author_sort N. G. Khorev
collection DOAJ
description 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.
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spelling doaj-art-ed1f127a785c4fbfb2f8634de520feb12025-08-20T03:05:27ZrusRemedium Group LTDАмбулаторная хирургия2712-87412782-25912022-05-01191444910.21518/1995-1477-2022-19-1-44-49249Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgeryN. G. Khorev0V. I. Kotov1V. O. Konkova2Altai State Medical University; Clinical Hospital “Russian Railways-Medicine” of the City of Barnaul; City Hospital No. 5Clinical Hospital “Russian Railways-Medicine” of the City of BarnaulAltai State Medical University; City Hospital No. 5Introduction. 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.https://www.a-surgeon.ru/jour/article/view/280femoral-popliteal bypass graftingreverse autoveinbiological prosthesismaleconduit
spellingShingle N. G. Khorev
V. I. Kotov
V. O. Konkova
Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
Амбулаторная хирургия
femoral-popliteal bypass grafting
reverse autovein
biological prosthesis
male
conduit
title Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
title_full Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
title_fullStr Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
title_full_unstemmed Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
title_short Some clinical and laboratory predictors of structural changes in the biological shunt after femoral-popliteal bypass surgery
title_sort some clinical and laboratory predictors of structural changes in the biological shunt after femoral popliteal bypass surgery
topic femoral-popliteal bypass grafting
reverse autovein
biological prosthesis
male
conduit
url https://www.a-surgeon.ru/jour/article/view/280
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AT vikotov someclinicalandlaboratorypredictorsofstructuralchangesinthebiologicalshuntafterfemoralpoplitealbypasssurgery
AT vokonkova someclinicalandlaboratorypredictorsofstructuralchangesinthebiologicalshuntafterfemoralpoplitealbypasssurgery