Surgical management of lower extremity peripheral arterial disease

Authors

  • Natawat Narueponjirakul Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  • Papawee Chennavasin Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Keywords:

Peripheral arterial disease, surgical management, lower extremity

Abstract

Becoming to aging society era, numbers of patients with peripheral arterial disease (PAD) have been continuously increasing. PAD is a presentation of atherosclerotic diseases. Most of the time, the patients are accompanied with underlying diseases that increase risks of atherosclerosis. Treatments of PAD essentially require multidisciplinary team supports. Smoking cessation, controlled exercise program, medical control for underlying diseases must be performed at the beginning of treatments. Revascularizations are indicated in the patients with unbearable symptoms and limb threatening ischemia. The reason why modern endovascular techniques have expeditiously been grown up is its advantage of less invasive and not to burn the bridge for future surgical bypass. However, its drawbacks are higher reintervention rates, contrast-induced nephropathy, radiation exposure, and lower long-term patency.

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References

Kullo IJ, Rooke TW. Clinical practice. Peripheral artery disease. N Engl J Med 2016;374:861-71.

https://doi.org/10.1056/NEJMcp1507631

Fowkes FG, Rudan D, Rudan I, Aboyans V, Denenberg JO, McDermott MM, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet 2013;382:1329-40. https://doi.org/10.1016/S0140-6736(13)61249-0

Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). Eur J Vasc Endovasc Surg 2007;33 Suppl 1:S1-75.

https://doi.org/10.1016/j.ejvs.2006.09.024

Joosten MM, Pai JK, Bertoia ML, Rimm EB, Spiegelman D, Mittleman MA, et al. Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men. JAMA 2012;308:1660-7. https://doi.org/10.1001/jama.2012.13415

Kallio M, Forsblom C, Groop PH, Groop L, Lepantalo M. Development of new peripheral arterial occlusive disease in patients with type 2 diabetes during a mean follow-up of 11 years. Diabetes Care 2003;26:1241-5. https://doi.org/10.2337/diacare.26.4.1241

Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med 2004;141:421-31.

https://doi.org/10.7326/0003-4819-141-6-200409210-00007

Meijer WT, Grobbee DE, Hunink MG, Hofman A, Hoes AW. Determinants of peripheral arterial disease in the elderly: the Rotterdam study. Arch Intern Med 2000;160:2934-8.

https://doi.org/10.1001/archinte.160.19.2934

Newman AB, Siscovick DS, Manolio TA, Polak J, Fried LP, Borhani NO, et al. Ankle-arm index as a marker of atherosclerosis in the Cardiovascular Health Study. Cardiovascular Heart Study (CHS) Collaborative Research Group. Circulation 1993;88:837-45. https://doi.org/10.1161/01.CIR.88.3.837

Murabito JM, D'Agostino RB, Silbershatz H, Wilson WF. Intermittent claudication. A risk profile from The Framingham Heart Study. Circulation 1997;96:44-9. https://doi.org/10.1161/01.CIR.96.1.44

Criqui MH, Vargas V, Denenberg JO, Ho E, Allison M, Langer RD, et al. Ethnicity and peripheral arterial disease: the San Diego Population Study. Circulation 2005;112:2703-7.

https://doi.org/10.1161/CIRCULATIONAHA.105.546507

Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. JAMA 2001;285:2481-5.https://doi.org/10.1001/jama.285.19.2481

Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res 2015;116:1509-26.

https://doi.org/10.1161/CIRCRESAHA.116.303849

Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation 1998;97:425-8.

https://doi.org/10.1161/01.CIR.97.5.425

Selvin E, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation 2004;110: 738-43. https://doi.org/10.1161/01.CIR.0000137913.26087.F0

Pradhan AD, Rifai N, Ridker PM. Soluble intercellular adhesion molecule-1, soluble vascular adhesion molecule-1, and the development of symptomatic peripheral arterial disease in men. Circulation 2002;106:820-5. https://doi.org/10.1161/01.CIR.0000025636.03561.EE

Khandanpour N, Loke YK, Meyer FJ, Jennings B, Armon MP. Homocysteine and peripheral arterial disease: systematic review and meta-analysis. Eur J Vasc Endovasc Surg 2009;38:316-22.

https://doi.org/10.1016/j.ejvs.2009.05.007

Pande RL, Creager MA. Socioeconomic inequality and peripheral artery disease prevalence in US adults. Circ Cardiovasc Qual Outcomes 2014;7:532-9.https://doi.org/10.1161/CIRCOUTCOMES.113.000618

Vart P, Coresh J, Kwak L, Ballew SH, Heiss G, Matsushita K. Socioeconomic status and incidence of hospitalization with lower-extremity peripheral artery disease: Atherosclerosis risk in communities study. J Am Heart Assoc 2017;6. pii: e004995. https://doi.org/10.1161/JAHA.116.004995

Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA 2006;295:180-9.

https://doi.org/10.1001/jama.295.2.180

Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al. Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 1997;26:517-38.

https://doi.org/10.1016/S0741-5214(97)70045-4

Conte MS, Pomposelli FB, Clair DG, Geraghty PJ, McKinsey JF, Mills JL, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg 2015;61(3 Suppl):2S-41S.

https://doi.org/10.1016/j.jvs.2014.12.009

Diehm C, Allenberg JR, Pittrow D, Mahn M, Tepohl G, Haberl RL, et al. Mortality and vascular morbidity in older adults with asymptomatic versus symptomatic peripheral artery disease. Circulation 2009;120:2053-61. https://doi.org/10.1161/CIRCULATIONAHA.109.865600

Leibson CL, Ransom JE, Olson W, Zimmerman BR, O'fallon WM, Palumbo PJ. Peripheral arterial disease, diabetes, and mortality. Diabetes Care 2004;27:2843-9.

https://doi.org/10.2337/diacare.27.12.2843

Sigvant B, Lundin F, Wahlberg E. The risk of disease progression in peripheral arterial disease is higher than expected: A meta-analysis of mortality and disease progression in peripheral arterial disease. Eur J Vasc Endovasc Surg 2016;51:395-403. https://doi.org/10.1016/j.ejvs.2015.10.022

Abu Dabrh AM, Steffen MW, Undavalli C, Asi N, Wang Z, Elamin MB, et al. The natural history of untreated severe or critical limb ischemia. J Vasc Surg 2015;62:1642-51.

https://doi.org/10.1016/j.jvs.2015.07.065

Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017;135:e726-79. https://doi.org/10.1161/CIR.0000000000000502

Aboyans V, Ricco JB, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. Editor's Choice - 2017 ESC Guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2018;55:305-68.

https://doi.org/10.1016/j.ejvs.2017.07.018

Conte MS, Pomposelli FB. Society for Vascular Surgery Practice guidelines for atherosclerotic occlusive disease of the lower extremities management of asymptomatic disease and claudication. Introduction. J Vasc Surg 2015;61(3 Suppl):1S. https://doi.org/10.1016/j.jvs.2014.12.009

Mills JL, Sr., Conte MS, Armstrong DG, Pomposelli FB, Schanzer A, Sidawy AN, et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg 2014;59:220-34.e1-2.

https://doi.org/10.1016/j.jvs.2013.08.003

Adam DJ, Beard JD, Cleveland T, Bell J, Bradbury AW, Forbes JF, et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomized controlled trial. Lancet 2005;366:1925-34.

https://doi.org/10.1016/S0140-6736(05)67704-5

Bradbury AW, Adam DJ, Bell J, Forbes JF, Fowkes FG, Gillespie I, et al. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: An intention-totreat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg 2010;51(5 Suppl):5S-17S. https://doi.org/10.1016/j.jvs.2010.01.073

Moses DA, Johnston LE, Tracci MC, Robinson WP 3rd , Cherry KJ, Kern JA, et al. Estimating risk of adverse cardiac event after vascular surgery using currently available online calculators. J Vasc Surg 2018;67:272-8. https://doi.org/10.1016/j.jvs.2017.06.105

Sigterman TA, Bolt LJ, Krasznai AG, Snoeijs MG, Heijboer R, Schurink GH, et al. Loss of kidney function in patients with critical limb ischemia treated endovascularly or surgically. J Vasc Surg 2016;64:362-8.

https://doi.org/10.1016/j.jvs.2016.03.409

Jaff MR, White CJ, Hiatt WR, Fowkes GR, Dormandy J, Razavi M, et al. An update on methods for revascularization and expansion of the TASC lesion classification to include below-the-knee arteries: A supplement to the inter-society consensus for the management of peripheral arterial disease (TASC II). J Endovasc Ther 2015;22:663-77. https://doi.org/10.1177/1526602815592206

Conte MS. Critical appraisal of surgical revascularization for critical limb ischemia. J Vasc Surg 2013; 57(2 Suppl):8S-13S. https://doi.org/10.1016/j.jvs.2012.05.114

Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg 2019;69:3S-125S e40.

Connolly JE, Price T. Aortoiliac endarterectomy: a lost art? Ann Vasc Surg 2006;20:56-62.

https://doi.org/10.1007/s10016-005-9101-9

Inahara T. Evaluation of endarterectomy for aortoiliac and aortoiliofemoral occlusive disease. Arch Surg 1975;110:1458-64. https://doi.org/10.1001/archsurg.1975.01360180028006

Vartanian SM, Conte MS. Surgical intervention for peripheral arterial disease. Circ Res 2015;116:1614-28. https://doi.org/10.1161/CIRCRESAHA.116.303504

Friedman SG, Lazzaro RS, Spier LN, Moccio C, Tortolani AJ. A prospective randomized comparison of Dacron and polytetrafluoroethylene aortic bifurcation grafts. Surgery 1995;117:7-10.

https://doi.org/10.1016/S0039-6060(05)80223-5

Roll S, Muller-Nordhorn J, Keil T, Scholz H, Eidt D, Greiner W, et al. Dacron vs. PTFE as bypass materials in peripheral vascular surgery-systematic review and meta-analysis. BMC Surg 2008;8:22.

https://doi.org/10.1186/1471-2482-8-22

Davidovic L, Vasic D, Maksimovic R, Kostic D, Markovic D, Markovic M. Aortobifemoral grafting: factors influencing long-term results. Vascular 2004;12:171-8. https://doi.org/10.1258/rsmvasc.12.3.171

Kalko Y, Ugurlucan M, Basaran M, Nargileci E, Banach M, Alpagut U, et al. Comparison of transperitoneal and retroperitoneal approaches in abdominal aortic surgery. Acta Chir Belg 2008;108:557-62. https://doi.org/10.1080/00015458.2008.11680285

Djedovic M, Rustempasic N, Djedovic S, Totic D, Solakovic S, Mujanovic E, et al. Comparison of transperitoneal and retroperitoneal approach in aorto iliac occlusive disease. Med Arch 2013;67:249-51.

https://doi.org/10.5455/medarh.2013.67.249-251

Tiek J, Remy P, Sabbe T, D'hont C, Houthoofd S, Daenens K, et al. Laparoscopic versus open approach for aortobifemoral bypass for severe aorto-iliac occlusive disease-a multicentre randomized controlled trial. Eur J Vasc Endovasc Surg 2012;43:711-5. https://doi.org/10.1016/j.ejvs.2012.02.003

Fourneau I, Lerut P, Sabbe T, Houthoofd S, Daenens K, Nevelsteen A. The learning curve of totally laparoscopic aortobifemoral bypass for occlusive disease. How many cases and how safe? Eur J Vasc Endovasc Surg 2008;35:723-9. https://doi.org/10.1016/j.ejvs.2008.01.005

Menard MT, Shah SK, Belkin M. Aortoiliac disease: direct reconstruction. In: Sidawy AN, Perler BA, editors. Rutherford's vascalar surgery and endovascular therapy. 9th ed. Vol. 2. Philadelphia, PA: Elsevier; 2014. p. 1397-415.

Hertzer NR, Bena JF, Karafa MT. A personal experience with direct reconstruction and extra-anatomic bypass for aortoiliofemoral occlusive disease. J Vasc Surg 2007;45:527-35.

https://doi.org/10.1016/j.jvs.2006.09.065

Nguyen KP, Perrone KH, Rahman A, Azarbal AF, Liem TK, Mitchell EL, et al. The role of axillofemoral bypass in current vascular surgery practice. Am J Surg 2016;211:968-71.

https://doi.org/10.1016/j.amjsurg.2016.02.003

Dickas D, Verrel F, Kalff J, Koscielny A. Axillobifemoral bypasses: reappraisal of an extra-anatomic bypass by analysis of results and prognostic factors. World J Surg 2018;42:283-94.

https://doi.org/10.1007/s00268-017-4150-0

Johnson WC, Lee KK. Comparative evaluation of externally supported Dacron and polytetrafluoroethylene prosthetic bypasses for femorofemoral and axillofemoral arterial reconstructions. Veterans Affairs Cooperative Study #141. J Vasc Surg 1999;30:1077-83.

https://doi.org/10.1016/S0741-5214(99)70046-7

Twine CP, McLain AD. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev 2010;(5): CD001487. https://doi.org/10.1002/14651858.CD001487.pub2

Faries PL, Logerfo FW, Arora S, Pulling MC, Rohan DI, Akbari CM, et al. Arm vein conduit is superior to composite prosthetic-autogenous grafts in lower extremity revascularization. J Vasc Surg 2000;31:1119-27. https://doi.org/10.1067/mva.2000.106488

Mills JL Sr. Infrainguinal disease: surgical treatment. In: Sidawy AN, Perler BA, editors. Rutherford's vascalar surgery and endovascular therapy. 9th ed. Vol. 2. Philadelphia, PA: Elsevier; 2014. p. 1438-62.

Rychlik IJ, Davey P, Murphy J, O'Donnell ME. A meta-analysis to compare Dacron versus polytetrafluroethylene grafts for above-knee femoropopliteal artery bypass. J Vasc Surg 2014;60:506-15.

https://doi.org/10.1016/j.jvs.2014.05.049

Kreienberg PB, Darling RC 3rd , Chang BB, Champagne BJ, Paty PS, Roddy SP, et al. Early results of a prospective randomized trial of spliced vein versus polytetrafluoroethylene graft with a distal vein cuff for limb-threatening ischemia. J Vasc Surg 2002;35:299-306. https://doi.org/10.1067/mva.2002.121208

Hartranft CA, Noland S, Kulwicki A, Holden CR, Hartranft T. Cryopreserved saphenous vein graft in infrainguinal bypass. J Vasc Surg 2014;60:1291-6. https://doi.org/10.1016/j.jvs.2014.05.092

Moody AP, Edwards PR, Harris PL. In situ versus reversed femoropopliteal vein grafts: long-term follow-up of a prospective, randomized trial. Br J Surg 1992;79:750-2.

https://doi.org/10.1002/bjs.1800790809

Conte MS. Challenges of distal bypass surgery in patients with diabetes: patient selection, techniques, and outcomes. J Am Podiatr Med Assoc 2010;100:429-38. https://doi.org/10.7547/1000429

Conte MS, Bandyk DF, Clowes AW, Moneta GL, Seely L, Lorenz TJ, et al. Results of PREVENT III: a multicenter, randomized trial of edifoligide for the prevention of vein graft failure in lower extremity bypass surgery. J Vasc Surg 2006;43:742-51. https://doi.org/10.1016/j.jvs.2005.12.058

Gibson A, Tevis S, Kennedy G. Readmission after delayed diagnosis of surgical site infection: a focus on prevention using the American College of Surgeons National Surgical Quality Improvement Program. Am J Surg 2014;207:832-9. https://doi.org/10.1016/j.amjsurg.2013.05.017

Davis FM, Sutzko DC, Grey SF, Mansour MA, Jain KM, Nypaver TJ, et al. Predictors of surgical site infection after open lower extremity revascularization. J Vasc Surg 2017;65:1769-78.

https://doi.org/10.1016/j.jvs.2016.11.053

Calligaro KD, Veith FJ, Schwartz ML, Dougherty MJ, DeLaurentis DA. Differences in early versus late extracavitary arterial graft infections. J Vasc Surg 1995;22:680-5.

https://doi.org/10.1016/S0741-5214(95)70058-7

Sriussadaporn S. The infected vascular graft. Chula Med J 1991;35:751-64.

Shoenfeld NA, O'Donnell TF, Bush HL Jr, Mackey WC, Callow AD. The management of early in situ saphenous vein bypass occlusions. Arch Surg 1987;122:871-5.

https://doi.org/10.1001/archsurg.1987.01400200021002

Markovic DM, Davidovic LB, Kostic DM, Maksimovic ZL, Kuzmanovic IB, Koncar IB, et al. False anastomotic aneurysms. Vascular 2007;15:141-8. https://doi.org/10.2310/6670.2007.00026

Batt M, Jean-Baptiste E, O'Connor S, Saint-Lebes B, Feugier P, Patra P, et al. Early and late results of contemporary management of 37 secondary aortoenteric fistulae. Eur J Vasc Endovasc Surg 2011;41:748-57. https://doi.org/10.1016/j.ejvs.2011.02.020

Olojugba DH, McCarthy MJ, Naylor AR, Bell PR, London NJ. At what peak velocity ratio value should duplex-detected infrainguinal vein graft stenoses be revised? Eur J Vasc Endovasc Surg 1998;15:258-60.

https://doi.org/10.1016/S1078-5884(98)80187-1

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Published

2023-07-19

How to Cite

1.
Narueponjirakul N, Chennavasin P. Surgical management of lower extremity peripheral arterial disease. Chula Med J [Internet]. 2023 Jul. 19 [cited 2024 Nov. 22];65(1). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/123