Prsentation PowerPoint - Place des pontages fmoro-poplits

Place des pontages fmoro-poplitsMarwan Abou-RjeiliCollge de Chirurgie VasculaireRgion Ile de France21 mai 2011

1INDICATIONS2CHEZ LE CLAUDICANT3Corriger les facteurs de risque cardiovasculairePas de limitation de la qualit de vielimitation de la qualit de vieTTT mdical premierSuspicion dune lsion proximaleAmliorationPas AmliorationIMAGERIEREVASCULARISATIONCONTINUER4Chez le patient en ischmie critiquePatient prsentant des douleurs de dcubitus et/ou des troubles trophiques depuis plus de 2 semaines causs par des lsions vasculaires avres5Corriger les facteurs de risque cardiovasculaire+REVASCULARISATION+IMAGERIE6TASC II

Stnose unique PTFE13

PTFE versus Autres prothsesPrimary patency at 24 months14

in situ versus Veine inverse en sus articulairePrimary patency 24 months.IN SITU=INVERSEE15Quel matriel utilisen SOUS-articulaire

16

PTFE versus Autres prthsesPrimary patency at 24 months17

in situ versus reversed Veine inverse en sus articulaireOutcome 4 Primary patency at 24 months.IN SITU50% RVHOccl + Stenose OVHsignificant coroEvent free EVHEvent free OpenLength follow upWound EVHWound OpenLength follow up woundsignificant woundtimepainConversionSystemcommentYun KLJ Thor Cardiovasc Surg200520078.30%82.40%68.10%70.00%no6 month7.40%19.40%6 monthyes1.80%VasoviewBonde PAnn Thor Surg2004583.80%28.60%36yesfasterbetterClearglidePerrault LPJ Thor Cardiovasc Surg20044084.40%85.20%no3noVasoviewAllen KBHeart Surg Forum2003112no75%74%60 monthyesBonde PHeart Surg Forum20026024yesequalyesClearglideSchurr UP ZHThorac Cardiovasc Surg20021400%18%3 monthyeslongeryesVasoviewKiaii BJ Thor Cardiovasc Surg20021444.30%24.60%1.5yesfasteryesEndovein Ethicon86% inf after dischargeHayward TZAnn Thor Surg199910018%20%1.5 monthnoequalnoEndovein Ethiconold system mini retractorCarpino PAJ Thor Cardiovasc Surg20001324.50%20%yeslongernoVasoviewAllen KBAnn Thor Surg1998112no96.10%98.30%1.54%19%yeslongerEndovein EthiconFolliguet TAEur J Cardiothorac Surg199860fasteryesWound ComplicationEndoscopic Vein HarvestOpen Vein HarvestYun KL 20057.40%19.40%Bonde P 20043.80%28.60%Schurr UP 20020%18%Kiaii B 20024.30%24.60%Carpino PA 20004.50%20%Hayward TZ 199918%20%Allen KB 19984%19%Angiographic follow upEVHOVHPerrault LP 2004 3month84.40%85.20%Yun KL 2005 6 month78.30%82.40%Event free Allen KBEVHOVH6 weeks96.10%98.30%60 months75%74%

Tabelle1

Endoscopic Vein HarvestOpen Vein HarvestWound Complication

Tabelle2

EVHOVHAngiographic permeability

Tabelle3

EVHOVHEvent free (Allen KB 2003)

Diagramm30.9610.9830.750.74

EVHOVHEvent free (Allen KB 2003)

Tabelle1TeamJournalDate of publicationnb patientCoro Pat EVHCoro Pat OpenOccl + Stenose >50% RVHOccl + Stenose OVHsignificant coroEvent free EVHEvent free OpenLength follow upWound EVHWound OpenLength follow up woundsignificant woundtimepainConversionSystemcommentYun KLJ Thor Cardiovasc Surg200520078.30%82.40%68.10%70.00%no6 month7.40%19.40%6 monthyes1.80%VasoviewBonde PAnn Thor Surg2004583.80%28.60%36yesfasterbetterClearglidePerrault LPJ Thor Cardiovasc Surg20044084.40%85.20%no3noVasoviewAllen KBHeart Surg Forum2003112no75%74%60 monthyesBonde PHeart Surg Forum20026024yesequalyesClearglideSchurr UP ZHThorac Cardiovasc Surg20021400%18%3 monthyeslongeryesVasoviewKiaii BJ Thor Cardiovasc Surg20021444.30%24.60%1.5yesfasteryesEndovein Ethicon86% inf after dischargeHayward TZAnn Thor Surg199910018%20%1.5 monthnoequalnoEndovein Ethiconold system mini retractorCarpino PAJ Thor Cardiovasc Surg20001324.50%20%yeslongernoVasoviewAllen KBAnn Thor Surg1998112no96.10%98.30%1.54%19%yeslongerEndovein EthiconFolliguet TAEur J Cardiothorac Surg199860fasteryesWound ComplicationEndoscopic Vein HarvestOpen Vein HarvestYun KL 20057.40%19.40%Bonde P 20043.80%28.60%Schurr UP 20020%18%Kiaii B 20024.30%24.60%Carpino PA 20004.50%20%Hayward TZ 199918%20%Allen KB 19984%19%Angiographic follow upEVHOVHPerrault LP 2004 3month84.40%85.20%Yun KL 2005 6 month78.30%82.40%Event free Allen KBEVHOVH6 weeks96.10%98.30%60 months75%74%

Tabelle100000000000000

Endoscopic Vein HarvestOpen Vein HarvestWound Complication

Tabelle20000

EVHOVHAngiographic permeability

Tabelle30000

EVHOVHEvent free (Allen KB 2003)

Diagramm20.8440.8520.7830.824

EVHOVHAngiographic permeability

Tabelle1TeamJournalDate of publicationnb patientCoro Pat EVHCoro Pat OpenOccl + Stenose >50% RVHOccl + Stenose OVHsignificant coroEvent free EVHEvent free OpenLength follow upWound EVHWound OpenLength follow up woundsignificant woundtimepainConversionSystemcommentYun KLJ Thor Cardiovasc Surg200520078.30%82.40%68.10%70.00%no6 month7.40%19.40%6 monthyes1.80%VasoviewBonde PAnn Thor Surg2004583.80%28.60%36yesfasterbetterClearglidePerrault LPJ Thor Cardiovasc Surg20044084.40%85.20%no3noVasoviewAllen KBHeart Surg Forum2003112no75%74%60 monthyesBonde PHeart Surg Forum20026024yesequalyesClearglideSchurr UP ZHThorac Cardiovasc Surg20021400%18%3 monthyeslongeryesVasoviewKiaii BJ Thor Cardiovasc Surg20021444.30%24.60%1.5yesfasteryesEndovein Ethicon86% inf after dischargeHayward TZAnn Thor Surg199910018%20%1.5 monthnoequalnoEndovein Ethiconold system mini retractorCarpino PAJ Thor Cardiovasc Surg20001324.50%20%yeslongernoVasoviewAllen KBAnn Thor Surg1998112no96.10%98.30%1.54%19%yeslongerEndovein EthiconFolliguet TAEur J Cardiothorac Surg199860fasteryesWound ComplicationEndoscopic Vein HarvestOpen Vein HarvestYun KL 20057.40%19.40%Bonde P 20043.80%28.60%Schurr UP 20020%18%Kiaii B 20024.30%24.60%Carpino PA 20004.50%20%Hayward TZ 199918%20%Allen KB 19984%19%Angiographic follow upEVHOVHPerrault LP 2004 3month84.40%85.20%Yun KL 2005 6 month78.30%82.40%Event free Allen KBEVHOVH6 weeks96.10%98.30%60 months75%74%

Tabelle100000000000000

Endoscopic Vein HarvestOpen Vein HarvestWound Complication

Tabelle20000

EVHOVHAngiographic permeability

Tabelle30000

EVHOVHEvent free (Allen KB 2003)