Use of distal venous patch in infrainguinal bypass revascularization with synthetic graft

Abstract

Background. Infrainguinal revascularization procedures are often the main in treating peripheral artery disease (PAD) and restoring vital blood flow to the lower extremities. Synthetic grafts such as PTFE or Dacron are considered when autogenous vein grafts are not available. Distal venous patches, strategically attached to these grafts, improve vascular dynamics, foster optimal healing, and augment vessel compliance. This reduces complications, prolongs graft viability, and improves results for limb preservation. Objective of the study. to meticulously evaluate venous patch efficacy in infrainguinal bypass revascularization with synthetic grafts. Aims include assessing their influence on graft patency optimization, complications mitigation, and long-term limb salvage rate augmentation. Material and methods. Systematic searches of PubMed and Google Scholar using keywords like „infrainguinal bypass”, „venous patch” and „synthetic graft”. Inclusion criteria focused on English-language peer-reviewed articles from the last two decades. Results. Studies reveal significant advantages of venous patches in infrainguinal bypass revascularization with synthetic grafts. Venous patches increase graft patency rates and decrease thrombosis and infections. Autogenous vein segments are preferred, with different dimensions and configurations observed. Subgroup examinations indicated benefits for older patients with vascular comorbidities. Limitations include surgical methodology disparities and potential biases in retrospective analyses. Conclusion. Distal venous patches have remarkable clinical effectiveness in infrainguinal bypass revascularization, improving graft patency and reducing complications. Despite limitations, they are key adjunctive strategies for enhancing the results of this procedure.