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The Anastomosis Angle Is a Key to Improved Long-Term Patency of Proximal Femoropopliteal Bypass

Publication at First Faculty of Medicine |


A significant proportion of Femoropopliteal bypasses become ineffective within 1 year because of occlusion due to progression of intimal hyperplasia (IH). Methods: The clinical part of the study involved an analysis of 43 patients with proximal femoropopliteal bypass, which became occluded no later than 1 year from the procedure.

Morphological changes of intima in the anastomosis and the angle of the distal end-to-side anastomosis were evaluated. In the second part of the study, blood flow in the distal end-to-side anastomosis.

Results: We proved that the locations of IH correlate with the locations of disturbed blood flow, increased wall shear stress, and stagnation points. We also confirmed that anastomoses with more acute angles are less prone to IH and occlusion of the lumen.

Conclusion: We suggest that a better understanding of the hemodynamics and its influence on IH should lead to an optimized graft design by adopting a more acute angle of the anastomosis.