| ViPS (Viabahn Padova Sutureless) Technique: Preliminary Results in the Treatment of Peripheral Arterial Disease. | |
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MedLine Citation:
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PMID: 22018501 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: To describe early results of a novel technique (ViPS, Viabahn Padova Sutureless) that connects a vascular prosthetic graft to a target artery in a sutureless fashion. METHODS: A consecutive series of five patients with peripheral arterial occlusive disease (Rutherford class IV and V) underwent six ViPS procedures (one bilateral) for limb revascularization. Angiography in all cases demonstrated complete superficial femoral artery (SFA) occlusion with reconstitution of a circumferentially calcified above-knee popliteal artery. Ultrasonography revealed no adequate vein for autogenous bypass creation. In all cases, a previous attempt of SFA endovascular recanalization was unsuccessful. A Viabahn (W.L. Gore, Flagstaff, AZ) endoprosthesis was partially deployed, and its proximal end was sutured to a polytetrafluoroethylene graft. After surgical exposure, the circumferentially calcified popliteal artery, which could not be safely sutured, was transected and the undeployed distal portion of the Viabahn was inserted into the popliteal artery supported by a stiff guidewire. The distal portion of the Viabahn graft was then deployed 2.5 cm into the popliteal artery with optimal apposition. The proximal end of the polytetrafluoroethylene graft was then sutured to the common femoral artery. The distal portion of the Viabahn was ballooned to ensure apposition with the popliteal artery. RESULTS: The mean time for surgical modification of the device was 6.6 minutes with a mean time for ViPS anastomosis deployment of 7 seconds. Mean operative time for ViPS procedure was 61 minutes (range: 48-74). Completion angiogram in all cases demonstrated a patent graft with no sign of dissection. The patients' symptoms resolved in all cases, with complete ulcer healing occurring in five patients within 3 weeks. Follow-up imaging (mean = 2.6 months, range: 1-5) with eco-color-Doppler and computed tomography angiogram demonstrated a patent graft with no loss of device integrity in all cases. CONCLUSION: The ViPS technique is simple, easily performed, and provides an alternative for bypass creation, particularly in cases where challenging arterial anastomoses are required. Furthermore, this technique has the potential to reduce operative time and is accomplished using common commercially available devices. |
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Authors:
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Luca Ferretto; Michele Piazza; Stefano Bonvini; Piero Battocchio; Franco Grego; Joseph J Ricotta |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-21 |
Journal Detail:
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Title: Annals of vascular surgery Volume: - ISSN: 1615-5947 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Clinic of Vascular and Endovascular Surgery, Padova University, School of Medicine, Padova, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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