Document Detail


End-to-end versus end-to-side proximal anastomosis in aortobifemoral bypass surgery: does it matter?
MedLine Citation:
PMID:  2054757     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The proximal anastomosis is still a controversial issue in vascular surgery. To compare end-to-end (EE) and end-to-side (ES) proximal anastomoses, the authors undertook a prospective study with 3 years' follow-up involving 120 patients, all of whom had aortobifemoral bypass. Fifty-one (42.5%) patients received the EE and 69 (57.5%) the ES anastomosis. The indications for surgery were abdominal aortic aneurysm (EE 51%, ES 0%; p less than 0.05), claudication (EE 33.3%, ES 53.6%; p less than 0.05) and critical ischemia (EE 15.7%, ES 46.4%; p less than 0.05). Patients in the EE group were older (mean age: EE 66.1 +/- 2.8 years, ES 60.9 +/- 1.1 years; p less than 0.05) and had more ischemic heart disease (EE 39.2%, ES 27.5%; p less than 0.05). Postoperative mean increases in transcutaneous oximetry (EE 15.5 +/- 3.9 mm Hg, ES 12.6 +/- 2.3 mm Hg) and the ankle-brachial pressure index (EE 0.34 +/- 0.05, ES 0.30 +/- 0.03) were not significantly different in the two groups. The operative death rate was higher for the EE group (EE 11.8%, ES 1.4%; p less than 0.05). Early thrombosis occurred in six patients, two in the EE group and four in the ES group. Computed tomography, done 1 year postoperatively in 95 patients, revealed two small (less than 3 cm) distal anastomotic dilatations, one in each group. At 3 years, cumulative survival and patency were similar in both groups. The authors conclude that the two anastomotic groups had very similar short- and long-term results, except for the operative death rate which was higher in the EE group.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
F M Ameli; M Stein; L Aro; J L Provan; R Gray; H Grosman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Canadian journal of surgery. Journal canadien de chirurgie     Volume:  34     ISSN:  0008-428X     ISO Abbreviation:  Can J Surg     Publication Date:  1991 Jun 
Date Detail:
Created Date:  1991-07-29     Completed Date:  1991-07-29     Revised Date:  2007-08-16    
Medline Journal Info:
Nlm Unique ID:  0372715     Medline TA:  Can J Surg     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  243-6     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Wellesley Hospital, University of Toronto, Ont.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anastomosis, Surgical / adverse effects,  methods,  mortality
Aorta, Abdominal / surgery*
Female
Femoral Artery / surgery*
Follow-Up Studies
Humans
Male
Middle Aged
Outcome and Process Assessment (Health Care)
Prospective Studies
Survival Rate
Vascular Patency

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


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