| Extra-anatomical bypass grafting--a single surgeon's experience. | |
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MedLine Citation:
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PMID: 20522294 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Extra-anatomical bypass grafting is a recognised method of lower limb re-vascularisation in high-risk patients who cannot tolerate aortic cross clamping, or in those with a hostile abdomen. We present a single surgeon series of such procedures and determine relevant outcomes. PATIENTS AND METHODS: A retrospective review was performed on a prospectively maintained database of patients undergoing femoro-femoral or axillo-femoral bypass surgery between 1986 and 2004. RESULTS: Patency rates for femoral (n = 28; 32%) versus axillary (n = 59; 68%) bypass procedures at 1 month, 1, 3 and 5 years were (92% vs 93%), (69% vs 85%), (60% vs 72%) and (55% vs 67%), respectively. Patient survival rates for the corresponding procedures and time intervals were (96% vs 90%), (96% vs 67%), (85% vs 45%) and (73% vs 38%) and revealed a significantly lower survival rate in those undergoing axillary procedures (P = 0.002). Limb salvage rates were calculated at (100% vs 91%), (96% vs 84%), (96% vs 81%) and (92% vs 81%) with no statistically significant difference found between the two groups (P = 0.124). Two-thirds of the patients who required major amputation died within 12 months of surgery. CONCLUSIONS: Acceptable 30-day morbidity, long-term primary patency and survival rates are obtainable in patients suitable for extra-anatomical bypass surgery despite having significant co-morbidities. We have shown 5-year patency rates in those that survive axillary procedures to be as good as those undergoing femoral procedures. Furthermore, surviving patients who evade amputation within a year have an excellent chance of long-term limb salvage. |
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Authors:
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N D Appleton; D Bosanquet; G Morris-Stiff; H Ahmed; P Sanjay; M H Lewis |
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Publication Detail:
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Type: Journal Article Date: 2010-06-01 |
Journal Detail:
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Title: Annals of the Royal College of Surgeons of England Volume: 92 ISSN: 1478-7083 ISO Abbreviation: Ann R Coll Surg Engl Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-07 Completed Date: 2010-10-13 Revised Date: 2013-05-29 |
Medline Journal Info:
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Nlm Unique ID: 7506860 Medline TA: Ann R Coll Surg Engl Country: England |
Other Details:
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Languages: eng Pagination: 499-502 Citation Subset: IM |
Affiliation:
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Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Axillary Artery / surgery Blood Vessel Prosthesis Implantation / methods* Epidemiologic Methods Female Femoral Artery / surgery Graft Occlusion, Vascular / etiology Humans Ischemia / surgery* Leg / blood supply* Limb Salvage / methods Male Middle Aged Postoperative Complications Treatment Outcome Vascular Patency |
| Comments/Corrections | |
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