{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:00:55Z","timestamp":1780059655132,"version":"3.54.0"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T00:00:00Z","timestamp":1681603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Autologous vein bypass provides excellent long-term results in critical limb-threatening ischemia (CLTI), but a substantial portion of patients have insufficient vein length. In limbs with two distal outflow vessels and limited vein length, a vascular prosthesis may be combined with autologous vein for a sequential composite bridge bypass (SCBB). Results regarding graft function, limb salvage and reinterventions are presented. Methods: Between January 2010 and December 2019, 47 consecutive SCBB operations with a heparin-bonded PTFE-prosthesis and autologous vein were performed. Grafts were followed with a duplex scan with prospective documentation in a computerized vascular database. Retrospective analysis of graft patency, limb salvage and patient survival was performed. Results: Mean follow-up was 34 months (range 1\u2013127 months). 30-day mortality was 10.6% and 5-year patient survival 32%. Postoperative bypass occlusion occurred in 6.4% and late occlusions or graft stenoses in 30%. Two prostheses developed late infection and seven legs were amputated. Primary, primary assisted, secondary patency and limb salvage rate were 54%, 63%, 66% and 85% after 5 years, respectively. Conclusions: SCBB patency and limb salvage were good despite a high early postoperative mortality. Combination of a heparin-bonded PTFE-prosthesis and autologous vein appears to be a valuable tool in CLTI in case of insufficient vein.<\/jats:p>","DOI":"10.3390\/jcm12082895","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T02:02:59Z","timestamp":1681696979000},"page":"2895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Results of Femorodistal Sequential Composite-Bypass Combining Heparin-Bonded PTFE-Prosthesis and Autologous Vein Using the Deutsch Bridge Technique in Critical Limb-Threatening Ischemia"],"prefix":"10.3390","volume":"12","author":[{"given":"Achim","family":"Neufang","sequence":"first","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerian","family":"Zhghenti","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany"},{"name":"Department of Vascular Medicine, Helios Dr. Horst Schmidt Hospital (Teaching Hospital of Johannes Gutenberg-University, Mainz), 65199 Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Vargas-Gomez","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Helios Dr. Horst Schmidt Hospital (Teaching Hospital of Johannes Gutenberg-University, Mainz), 65199 Wiesbaden, Germany"},{"name":"Vascular Surgery, University Hospital Son Espases, 07120 Palma de Mallorca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Umscheid","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Helios Dr. Horst Schmidt Hospital (Teaching Hospital of Johannes Gutenberg-University, Mainz), 65199 Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"von Flotow","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Westpfalz-Klinikum II Kusel (Teaching Hospital of Johannes Gutenberg-University School of Medicine), 66869 Kusel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Schmiedel","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Westpfalz-Klinikum II Kusel (Teaching Hospital of Johannes Gutenberg-University School of Medicine), 66869 Kusel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savvas","family":"Savvidis","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, Helios Dr. Horst Schmidt Hospital (Teaching Hospital of Johannes Gutenberg-University, Mainz), 65199 Wiesbaden, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2305","DOI":"10.1056\/NEJMoa2207899","article-title":"Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia","volume":"387","author":"Farber","year":"2022","journal-title":"N. 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