Society For Clinical Vascular Surgery

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Clinical Experience with Gore Hybrid Vascular Graft in Complex Revascularizations Demonstrates Safety and Efficacy
John J. Nguyen-Lee, MD, Mujeeb Zubair, MD, Halim Yammine Yammine, MD, Vishwanath Chegireddy Chegireddy, MD, Thomas Loh, MD, Matthew E. Bennett, MD, Alan B. Lumsden, MD, Carlos F. Bechara, MD, Jean Bismuth, MD.
Houston Methodist Surgery, Houston, TX, USA.

OBJECTIVES: Arterial revascularizations can present significant challenges when vessels are disadvantaged (porcelain vessels, dissection, etc). Advances in technology present the surgeon with innovative opportunities. There are a number of publications using the GOREŽ Hybrid Vascular Graft (GHVG), and we have been using this device in arterial revascularizations since it came to market. The aim of this study is therefore to present a large single center experience using the GHVG. The series presents patients with complex revascularizations in multiple vascular beds.
METHODS: We retrospectively analyzed a single center series of 43 patients who received a total of 56 GHVGs in complex revascularization procedures at Houston Methodist Hospital from March 2012 to April 2017. We excluded 5 patients (7 grafts in total) due to loss of follow up. An additional 8 patients were excluded from analysis (11 grafts in total) secondary to mortalities unrelated to their grafts (7 patients died during index hospitalization and 1 patient died shortly after discharge).
RESULTS: Our results demonstrated an 18 month primary patency, assisted primary patency and secondary patency of 82%, 86%, and 96 % respectively. These complex revascularizations included a total of 56 stents placed. GHVGs were placed in the external iliac artery (26/56), renal artery (12/56), common femoral artery (6/56), superficial femoral artery (4/56), common iliac artery (3/56), grafts (3/56), profunda femoris artery (1/56), and the superior mesenteric artery (1/56). Early mortality in patients (7/8) was due to the nature of their disease and not related to the surgical intervention.
CONCLUSIONS: These results demonstrate the value of GHVG in complex revascularizations not amenable to traditional open surgical bypass secondary to extensively calcified vessels and multiple comorbidities.

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