{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:39:27Z","timestamp":1789501167812,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T00:00:00Z","timestamp":1679788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Surgical bypass is the gold standard treatment in patients affected by chronic limb-threatening ischemia in advanced GLASS stages, according to the Global Vascular Guidelines. For patients in whom an autologous graft is not available, a prosthesis could be used with the adjunct of a distal arteriovenous fistula interposition. The aim of this study was to examine the long-term results of below-the-knee surgical revascularization using a prosthesis with the distal adjunct mentioned above. From 2010 to 2020, we performed 159 lower limb below-the-knee surgical revascularizations using a prosthesis with the creation of an arteriovenous fistula interposition on the distal anastomosis. The GLASS stage was 3 in 100% of patients. The primary patency rates were as follows: 86.7% at 1 year, 57.2% at 3 years, and 12.6% at 5 years. The graft thrombosis rates were 17.4% at 1 year, 42.1% at 3 years, and 64.5% at 5 years. The amputation-free survival rates were 79% at 1 year, 76% at 3 years, and 64% at 5 years. PTFE prosthetic bypass for below-the-knee arteries using an arteriovenous fistula interposition is a good solution in patients without an autologous conduit. This technique offers reasonable graft patency and limb salvage rates.<\/jats:p>","DOI":"10.3390\/diagnostics13071246","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:38:36Z","timestamp":1679881116000},"page":"1246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-Term Results of Below-The-Knee Bypass Using a Prosthetic Graft with a Distal Arteriovenous Fistula Interposition"],"prefix":"10.3390","volume":"13","author":[{"given":"Francesco","family":"Spinelli","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Department of Medicine and Surgery, University Hospital Foundation Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Roscitano","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Specialties, University of Catania, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4675-7901","authenticated-orcid":false,"given":"David","family":"Barill\u00e0","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery Unit, Grande Ospedale Metropolitano \u201cBianchi-Melacrino-Morelli\u201d, 89124 Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziana","family":"Derone","sequence":"additional","affiliation":[{"name":"Vascular Surgery Department, Ospedale dell\u2019Angelo, 30171 Venezia Mestre, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4069-6781","authenticated-orcid":false,"given":"Antonio","family":"Nenna","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Unit, Department of Medicine and Surgery, University Hospital Foundation Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0983-7045","authenticated-orcid":false,"given":"Nunzio","family":"Montelione","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Medicine and Surgery, University Hospital Foundation Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Catanese","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Medicine and Surgery, University Hospital Foundation Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cutrupi","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery Unit, Grande Ospedale Metropolitano \u201cBianchi-Melacrino-Morelli\u201d, 89124 Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina Maria","family":"Giambra","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Specialties, University of Catania, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0464-0975","authenticated-orcid":false,"given":"Alessandra","family":"Varr\u00e0","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Specialties, University of Catania, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Francesco","family":"Veroux","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical Specialties, University of Catania, 95100 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Stilo","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Medicine and Surgery, University Hospital Foundation Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.ejvs.2019.05.006","article-title":"GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS). 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