Performing Infrainguinal Bypass?

Bring the Precision of CABG to Lower Limb Revascularization

For patients with Peripheral Artery Disease (PAD) in the lower extremities, infrainguinal bypass can mean the difference between mobility and amputation. In some cases, it even makes the difference between life and death.

Just like CABG, the success of lower limb bypass relies on restoring proper blood flow. While CABG is performed to protect heart muscle, infrainguinal bypass is performed to preserve the limb. The goals are different, but the need for precision is the same.

And that precision comes from measuring flow in the OR – before closing the patient, while still within in the opportune time to make adjustments.

Why Flow Measurement Matters for Lower Limb Bypass

A successful infrainguinal bypass requires three things: good inflow, good outflow and a patent graft. While it sounds simple, even the most experienced surgeons can encounter unexpected complications during the procedure.

The benefits of using Transonic’s Transit-Time Flow Measurement technology for intraoperative graft assessment during cardiac surgery are well documented and widely known. Now, it’s time to bring that same precision to the legs.

Measuring flow with the Transonic Vascular Flowprobes (FMV-Series) and Transonic Optima Flowmeter gives you the data to support clinical decision-making so you can:

Detect technical issues in real-time like graft twists, strictures or poor anastomotic connections
Ensure functional blood flow through the bypass before you close
Optimize surgical decisions in the OR to improve long-term outcomes

Transonic’s flow measurement tools offer quantitative, on-the-spot datato back up your clinical judgment.

Fem-Pop, Fem-Fem, Fem-Tib. It All Matters

Lower limb bypasses come in many forms, such as:

Femoral-popliteal (Fem-Pop)
Femoral-femoral (Fem-Fem)
Femoral-tibial (Fem-Tib)
Aortofemoral or axillofemoral bypasses

No matter the configuration, flow is a constant that determines graft success. A study of critical limb ischemia patients, for instance, showed that 75–85% of untreated high-risk patients required amputation within a year. With early revascularization and proper intraoperative monitoring, these outcomes can be improved.

The Research Says

An analysis by Wolfe and Wyatt of 20 publications reporting the results of 6,118 patients with critical limb ischemia, grouped into low-risk and high-risk groups, reported that 75% of the low-risk patients and 85% of the high-risk patients who did not have revascularization surgery required amputation within one year. Welborn III, Yau and Seeger suggest that 25% to 40% of patients with ischemia rest pain and 80% of those with tissue loss will require amputation at one year if they are not revascularized.

Source: Welborn III, M.B., Yau, F.S., Seeger, J.M., “The Natural History and Noninvasive Treatment of Lower-extremity Arterial Occlusive Disease,” Chapter 43,
Mastery of Vascular and Endovascular Surgery, Zelenock, G.B., Wilson, T.S., Messina, L.M., Lumsden, A.B., Moneta, G.L., editors, Lippincott Williams & Wilkins, Philadelphia, 2006.

Doppler vs. Transit-Time Flow Measurement: Which Is Better?

Doppler ultrasound has long been used in vascular surgery, but it has several critical limitations. It gives you sound and waveform, but not hard numbers.

That’s where transit-time flow measurement (TTFM) steps in.

Unlike Doppler, TTFM gives you quantitative, real-time measurements of actual blood flow through the graft measured in mL/min. It’s objective data you can act on immediately.

Doppler can suggest there’s flow. TTFM tells you how much.
Doppler can suggest a possible absence of flow. TTFM detects low or inadequate flow that could still lead to graft failure.
Doppler gives a “yes or no” answer. TTFM gives you a quantifiable number and a clear threshold to guide intraoperative decisions.

For vascular surgeons, TTFM isn’t just an upgrade. It’s a must for saving limbs and lives.

Helping You Optimize Your Outcomes.

Transonic’s graft flow measurements offer a clear window into what’s happening inside the vessel, helping you catch potential problems early on. Connect with us to learn more about bringing the same level of data-driven decision-making to limb-saving surgery as to CABG.