Innovative Technique for Below the Knee Arterial Revascularisation Using Porcine Self Made Stapled Pericardial Tube Grafts

Elisabeth Côté; Rafael Trunfio; Celine Deslarzes-Dubuis; Kenneth Tran; Jean-Marc Corpataux; Sebastien Déglise

doi:10.1016/j.ejvsvf.2020.06.002

Innovative Technique for Below the Knee Arterial Revascularisation Using Porcine Self Made Stapled Pericardial Tube Grafts

EJVES Vasc Forum. 2020 Jun 27:48:23-26. doi: 10.1016/j.ejvsvf.2020.06.002. eCollection 2020.

Authors

Elisabeth Côté¹, Rafael Trunfio¹, Celine Deslarzes-Dubuis¹, Kenneth Tran^{1

2}, Jean-Marc Corpataux¹, Sebastien Déglise¹

Affiliations

¹ Department of Vascular Surgery, University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
² Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Abstract

Introduction: When no autologous vein is available for distal bypass in the setting of chronic limb threatening ischaemia (CLTI), new alternatives are required to solve the problems of availability, patency, and resistance to infection. An innovative technique of below the knee bypass for CLTI using a porcine self made stapled pericardial tube graft is reported.

Report: An 84 year old man, admitted with right CLTI with foot infection due to long occlusion of the femoropopliteal segment, required urgent revascularisation. In the absence of autologous vein and cryopreserved vessels, a 4 mm self made stapled porcine pericardial tube graft 56 cm long was created from two 14 × 8 cm patches, to perform a femorotibioperoneal trunk bypass. On day 10, bypass thrombectomy and balloon angioplasty of the distal anastomosis were needed to treat early occlusion. Oral anticoagulation was then started. Right toe pressure increased from 0 to 70 mmHg, and no infection was reported. Complete wound healing was achieved. At six months, the bypass was still patent.

Discussion: The use of porcine self made stapled pericardial tube grafts could offer new options for revascularisation in CLTI. Larger cohort studies with longer follow up are needed to confirm this successful preliminary experience.

Keywords: Chronic limb threatening ischaemia; Distal bypass; Pericardial tube.