Difference between revisions of "Infrainguinal arterial bypass"
From WikiAnesthesia
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* Aortofemoral bypass or aortobifemoral bypass | * Aortofemoral bypass or aortobifemoral bypass | ||
* Axillofemoral bypass or axillobifemoral bypass | * Axillofemoral bypass or axillobifemoral bypass | ||
* Femorofemoral bypass (fem-fem) | * Femorofemoral bypass (fem-fem) | ||
*Femoral popliteal bypass (fem-pop) | |||
* Femoral tibial bypass (fem-tib) | * Femoral tibial bypass (fem-tib) | ||
| Line 20: | Line 20: | ||
=== Indications === | === Indications === | ||
Severely PAD causing claudication, ulceration, or infection | |||
=== Surgical procedure === | === Surgical procedure === | ||
* Incision of bypass sites (source and target arteries) | |||
* ± Harvest of vein graft | |||
* Anastomotic tunnel creation | |||
* Clamp of proximal artery | |||
* Distal anastomosis, then proximal anastomosis | |||
* Reperfusion of arteries | |||
* Arteriogram to confirm flow | |||
== Preoperative management == | == Preoperative management == | ||
Revision as of 18:16, 4 April 2022
Infrainguinal arterial bypass
| Anesthesia type |
General |
|---|---|
| Airway |
ETT |
| Lines and access |
2 large bore PIVs, arterial line |
| Monitors |
Standard ASA, ABP |
| Primary anesthetic considerations | |
| Preoperative |
Other comorbid conditions including CAD, HTN, DM often present |
| Intraoperative |
Reperfusion after cross clamp may cause acidosis, ATN, hyperkalemia |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Infrainguinal arterial bypass procedures include:
- Aortofemoral bypass or aortobifemoral bypass
- Axillofemoral bypass or axillobifemoral bypass
- Femorofemoral bypass (fem-fem)
- Femoral popliteal bypass (fem-pop)
- Femoral tibial bypass (fem-tib)
Overview
Indications
Severely PAD causing claudication, ulceration, or infection
Surgical procedure
- Incision of bypass sites (source and target arteries)
- ± Harvest of vein graft
- Anastomotic tunnel creation
- Clamp of proximal artery
- Distal anastomosis, then proximal anastomosis
- Reperfusion of arteries
- Arteriogram to confirm flow
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway | |
| Neurologic | |
| Cardiovascular | |
| Pulmonary | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Tony Wang, Jashvin Patel and Chris Rishel