Document Detail


Aortic reconstructive surgery for limb ischaemia: immediate and long-term follow-up to provide a standard for endovascular procedures.
MedLine Citation:
PMID:  9705097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Aortobifemoral and aortobiliac bypass has been a preferred treatment of severe aortoiliac occlusive disease. Recently, endovascular procedures and unilateral bypass grafting have been introduced. We report the results of aortic reconstructive surgery over a 19-year period (1975-1994). METHODS: A total of 285 patients underwent surgery. Follow-up data from clinical notes, general practitioner questionnaire or phone interview was available in 93.3% (266/285). RESULTS: Of the total 68% were male (180/226) and the median age was 63 years (range 22-85 years). Indications for surgery were tissue loss/gangrene (n = 32), rest pain (n = 84), severe claudication (n = 40), moderate claudication (n = 110). Total of 177 bifurcated grafts, 51 iliofemoral, eight left/right aortofemoral, and 30 other procedures were performed. The median duration of follow-up was 49.8 months. Cumulative secondary graft patency for 2, 5 and 10 years was 97.7%, 95.9%, and 94.4%. The amputation rate was 4.5% (12/266). Early mortality occurred in eight of 266 patients (3%) and late mortality in 60 patients. The most common cause of late death was ischaemic heart disease (24/60 followed by cancer (14/60). Data was further analysed by type of graft, risk factors, complications and previous and subsequent surgery. In our experience, aortic reconstructive surgery is a successful option for the management of severe aortoiliac occlusive disease. The outcome of other methods of maintaining arterial patency should be measured against this standard.
Authors:
R A Harris; D T Hardman; C Fisher; R Lane; M Appleberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  6     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-10-07     Completed Date:  1998-10-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  256-61     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aorta, Abdominal / surgery*
Blood Vessel Prosthesis Implantation* / methods
Female
Follow-Up Studies
Humans
Ischemia / surgery*
Leg / blood supply*
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Treatment Outcome
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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