R Sacilotto

Publications (2)5.84 Total impact

• Article: Limb salvage using bypass to the perigeniculate arteries.

  N De Luccia, P Sassaki, A Durazzo, G Sandri, M Kikuchi, C Hirata, M Romiti, R Sacilotto, F C Brochado-Neto
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  ABSTRACT: To describe bypass to perigeniculate vessels for limb salvage. Retrospective cohort study. Between 1995 and 2009, 47 bypass procedures to perigeniculate collateral arteries were performed in 46 patients (15 women, 31 men; median age, 68 years). All patients presented with critical ischaemia (tissue loss in 87.5%, rest pain in 12.5%). Mean ankle brachial index was 0.27 ± 0.17. The site of distal anastomosis was the descending genicular artery (DGA) in 23 bypasses (1 bilateral) and the medial sural artery (MSA) in 24. Proximal anastomosis was to the external iliac artery in 2 cases, common femoral artery in 23 cases, superficial femoral artery in 8 cases, deep femoral artery in 8 cases, above-knee poplitaeal artery in 2 cases, and previous graft in 4 cases. There were four deaths during the immediate postoperative period. Mean follow-up duration was 27 months. Ten patients required major amputation. Mean ankle brachial index post-operatively was 0.60 ± 0.21. At 3 years, primary patency was 74.7 ± 7%, secondary patency was 83.4 ± 8%, and the limb salvage and survival rates were 73.5 ± 7% and 77.4 ± 7%, respectively. Bypass to perigeniculate arteries is a viable treatment option for critical limb ischaemia in selected patients.
  European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 05/2011; 42(3):374-8. · 2.92 Impact Factor
• Article: Inframalleolar bypass grafts for limb salvage.

  F C Brochado Neto, M V M Cury, V S Costa, I B Casella, M F Matielo, E T Nakamura, C S Pecego, R Sacilotto
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  ABSTRACT: To report our experience of long-term results of inframalleolar bypass. Retrospective analysis. We analysed 122 inframalleolar bypasses performed between January 1991 and June 2005 in 116 patients. Most patients were treated for critical ischaemia (97%). The indication for the use of podalic arteries was a lack of tibial arteries with run-off to the foot. The dorsalis pedis was predominantly used for distal anastomoses (62.3%) and the greater saphenous vein (84.4%) as the conduit. The follow-up periods ranged from 1 to 60 months. The endpoints analysed were graft patency, limb salvage, preservation of deambulation and survival rate. The cumulative patency was 58.2% at 3 years and 53.4% at 5 years. The best results were achieved with the devalvulated greater saphenous veins. Limb salvage was 70.0% at 3 years and 50.4% at 5 years, with preserved deambulation rates of 57.3% and 47.1%, respectively. There were 36 major and 45 minor amputations. At 3 years, the survival rate was 50.2% and the surgical mortality 13%. Female sex was associated with worse results for cumulative patency and limb salvage (P<0.01). In the long term, inframalleolar bypass is a satisfactory option for limb salvage.
  European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 09/2010; 40(6):747-53. · 2.92 Impact Factor