Comparison of sutureless anastomosis with hybrid vascular graft to standard graft for the hypogastric preservation during open aortic surgery

BACKGROUND: The aim of this study was to evaluate the results of surgical bypass to the hypogastric artery (HA) during open surgical interventions for aortoiliac disease using the novel hybrid vascular graft (GHVG) in comparison with a standard graft. METHODS: This is a retrospective, observational cohort study from tertiary referral university hospitals. Specifically for this study, post-hoc analysis identified all patients treated with open surgical aortoiliac/femoral graft reconstruction who underwent direct HA bypass, between January 1, 2015, and December 31, 2020. For this study, primary outcomes of interest were early (≤30 day) mortality, freedom from pelvic ischemic complications, and primary patency of the HAbypass. RESULTS: The final comparative analysis included 22 patients. Standard prosthetic graft (group A) was used in 15 cases, and GHVG (group B) was used in 7. Intraoperative mortality was 0%. There was no difference in mean operative time (minutes: 310±43 vs. 332±92, P=0.641), mean blood loss (mL, 1570±915 vs. 1060±555, P=0.318), postoperative complications (OR=0.2; P=0.247), and mean hospitalization (days: 11±5 vs. 8±3, P=0.231). All patients are alive at a median follow-up of 28 months (range: 9-57). Estimated primary patency did not differ between the two groups (Log-rank, P=0.314). CONCLUSIONS: In our experience, direct HArevascularization is safe using either the sutureless technique or standard graft. Despite early technical failures, which call attention to meticulous surgical technique, GHVGshowed long-term results like a standard graft.