Potentials of Using Allografts in Surgical Treatment of Popliteal Artery Aneurysms

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: The gold standard in reconstructive surgical operations on the infrainguinal arteries is the autovenous conduit from the great saphenous vein. However, in the absence of a suitable autovein, difficulties are encountered in the selection of a suitable material for reconstruction. The use of a synthetic prosthesis as an alternative in the knee joint region is not always possible, especially in the distal position. Unsatisfactory results of using such materials dictate the need to choose a suitable graft. The paper describes two case experiences of using allografts from a deceased donor for the surgical treatment of popliteal artery aneurysms. The cases present their potential for use in emergency clinical situations. In the first case, the patient had previously undergone phlebectomy. In the second case, the saphenous veins of the lower limbs had scattered branches and insufficient diameter for reconstruction.

CONCLUSION: The described cases presented the possible effective use of allografts from a deceased donor in patients with true popliteal artery aneurysms.

About the authors

Roman E. Kalinin

Ryazan State Medical University

Email: kalinin-re@yandex.ru
ORCID iD: 0000-0002-0817-9573
SPIN-code: 5009-2318

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ryazan

Igor′ A. Suchkov

Ryazan State Medical University

Email: suchkov_med@mail.ru
ORCID iD: 0000-0002-1292-5452
SPIN-code: 6473-8662

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ryazan

Vyacheslav V. Karpov

Regional Clinical Hospital

Author for correspondence.
Email: sdrr.s@yandex.ru
ORCID iD: 0000-0001-5523-112X
SPIN-code: 6245-6292

MD, Cand. Sci. (Med.)

Russian Federation, Ryazan

Andrey A. Egorov

Ryazan State Medical University; Regional Clinical Hospital

Email: eaa.73@mail.ru
ORCID iD: 0000-0003-0768-7602
SPIN-code: 2408-4176

MD, Dr. Sci. (Med.)

Russian Federation, Ryazan; Ryazan

References

  1. Pokrovskiy AV, editor. Klinicheskaya angiologiya. Moscow: Meditsina; 2004;1:145–7, 180–90. (In Russ).
  2. Cronenwett JL, Johnston KW. Rutherford’s Vascular Surgery. 8th ed. Elsevier; 2014.
  3. Dawson I, Sie R, van Baalen JM, et al. Asymptomatic popliteal aneurysm: elective operation versus conservative follow-up. British Journal of Surgery. 1994;81(10):1504–7. doi: 10.1002/bjs.1800811035
  4. Guvendik L, Bloor K, Charlesworth D. Popliteal aneurysm: sinister harbinger of sudden catastrophe. British Journal of Surgery. 1980;67(4): 294–6. doi: 10.1002/bjs.1800670422
  5. Greenhalgh RМ. Vascular and Endovascular Controversies Update — 40 Years of Looking Forward. BIBA Publishing; 2018.
  6. Edwards WS. Exclusion and saphenous vein bypass of popliteal aneurysms. Surgery, Gynecology & Obstetrics. 1969;128(4):829–30.
  7. Tielliu IFJ, Verhoeven ELG, Zeebregts CJ, et. al. Endovascular treatment of popliteal artery aneurysms: results of a prospective cohort study. Journal of Vascular Surgery. 2005;41(4):561–7. doi: 10.1016/j.jvs.2004.12.055
  8. Woody JD, Makaroun MS. Popliteal artery aneurysms. In: Vascular Surgery. 2003;(Ch 7):57–63. doi: 10.1007/978-1-4471-3870-9_7
  9. Neville RF, Tempesta B, Sidway AN. Tibial bypass for limb salvage using polytetrafluoroethylene and a distal vein patch. Journal of Vascular Surgery. 2001;33(2):266–71; discussion 271–2. doi: 10.1067/mva.2001.113131
  10. Pokrovsky AV, Dan VN, Zotikov AE, et al. Long-term outcomes of femoropopliteal bypass above the knee-joint fissure by means of vascular prosthesis "Ecoflon" in patients with atherosclerotic lesions of lower limb arteries. Angiology and Vascular Surgery. 2007;13(2):143–9. (In Russ).
  11. Kalinin RE, Suchkov IA, Klimentova EA, et al. Apoptosis in vascular pathology: present and future. I.P. Pavlov Russian Medical Biological Herald. 2020;28(1):79–87. (In Russ). doi: 10.23888/PAVLOVJ202028179-87
  12. Kalinin RE, Suchkov IA, Pshennikov AS. Correction of endothelial dysfunction as a component in treatment for atherosclerosis obliterans of lower limb arteries. Angiology and Vascular Surgery. 2014;20(3):17–22. (In Russ).
  13. Strelnikova EA, Trushkina PYu, Surov IYu, et al. Endothelium in vivo and in vitro. Part 1: histogenesis, structure, cytophysiology and key markers. Sciences of the young (Eruditio Juvenium). 2019;7(3):450–65. (In Russ). doi: 10.23888/ HMJ201973450-465
  14. Kalinin RE, Suchkov IA, Mzhavanadze ND, et al. Comparison of cytotoxicity of vascular prostheses in vitro. I.P. Pavlov Russian Medical Biological Herald. 2020;28(2):183–92. (In Russ). doi: 10.23888/PAVLOVJ2020282183-192
  15. Lebedev LV, Plotkin LL, Smirnov AD, et al. Protezy krovenosnykh sosudov. 4th ed. Saint–Petersburg: Admiralteystvo; 2001. (In Russ).
  16. Mezzetto L, Scorsone L, Pacca R, et al. Treatment of popliteal artery aneurysms by means of cryopreserved homograft. Annuals of Vascular Surgery. 2015;29(6):1090–6. doi: 10.1016/j.avsg.2015.02.007
  17. Heinola I, Kantonen I, Mattila I, et al. Cryopreserved Venous Allografts in Supra-inguinal Reconstructions: A Single Centre Experience. European Journal of Vascular and Endovascular Surgery. 2019;58(6):912–9. doi: 10.1016/j.ejvs.2019.06.024
  18. Podlaha J. Twenty years operating experience for popliteal artery aneurysm. Acta Chirurgica Belgica. 2007;107(5):540–3. doi: 10.1080/00015458.2007.11680118
  19. Kalinin RE, Suchkov IA, Karpov VV, et al. The First Experience of Using Allografts in Surgery of Main Arteries of Lower Limbs. Russian Sklifosovsky Journal of Emergency Medical Care. 2020;9(3):442–8. (In Russ). doi: 10.23934/2223-9022-2020-9-3-442-448
  20. Muhamadeev IS, Fried GG, Berezina IA. The evaluation of arterial and venous allografts viablity in vitro depending on the period of preservation. Morphological Newsletter. 2007;(1–2):197–201. (In Russ).
  21. Natsional’nyye rekomendatsii po diagnostike i lecheniyu zabolevaniy arteriy nizhnikh konechnostey. Moscow; 2019. Available at: http://www.angiolsurgery.org/library/recommendations/2019/recommendations_LLA_2019.pdf. Accessed: 2021 July 20. (In Russ).
  22. Randon C, Jacobs B, de Ryck F, et al. Fifteen years of infrapopliteal arterial reconstructions with cryopreserved venous allografts for limb salvage. Journal of Vascular Surgery. 2010;51(4):869–77. doi: 10.1016/j.jvs.2009.11.062

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 2. Case report 1. Scan of the posterior tibial artery near the medial malleolus.

Download (18KB)
Indexing metadata
3. Fig. 3. Case report 2. Peripheral anastomosis of the graft and popliteal artery.

Download (31KB)
Indexing metadata
4. Fig. 4. Case report 2. Control examination after three months: postoperative wounds.

Download (24KB)
Indexing metadata
5. Fig. 1. Case report 1. Prosthetics of the popliteal artery using an arterial allograft with ligation of the true thrombosed aneurysm on the left: central anastomosis of the allograft and popliteal artery (a); peripheral anastomosis of the allograft and popliteal artery (b).

Download (66KB)
Indexing metadata

Copyright (c) 2022 ООО "Эко-Вектор"


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies