Document Detail


Femoro-femoral arterial bypass is an effective and durable treatment for symptomatic unilateral iliac artery occlusion.
MedLine Citation:
PMID:  12648336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: This study was designed to determine the effectiveness of femoro-femoral arterial bypass (FFB) operation at hospital discharge and 1 year after operation, and to determine the role of long saphenous vein (LSV) as a conduit. METHODS AND RESULTS: A retrospective review was undertaken of 161 consecutive patients (median age, 66 years; range, 44-97 years) who had femoro-femoral grafts during the 12 years from July 1987 to March 1999. The indication for operation was claudication in 66 patients and critical ischaemia in 95. A synthetic graft was used in 123 patients and LSV in 38. Six patients with LSV had a previously infected synthetic graft and 2 a previously occluded synthetic graft. In-hospital operative mortality was 13 (8.1%). One year postoperatively, known mortality was 29, fifteen patients were lost to follow-up putting 1-year mortality at 18.0-27.3%. Eight of these had LSV as the conduit. At discharge from hospital, the median improvement in the ankle brachial pressure index was 0.3 (range, 0-1.0) overall, and 0.32 for patients with LSV (range 0-1.0). Among the 117 known survivors at 1 year, secondary graft patency was 107 confirmed by Doppler or duplex (91.5%) overall, and 25 (89.3%) for LSV; 100 (85.5%) maintained symptomatic improvement, 11 (9.4%) were experiencing no benefit and 6 (5.1%) were worse, of whom 2 had undergone amputation. In patients in whom LSV was used, 22 (78.8%) remained symptomatically improved, 3 (10.7%) experienced no benefit, 3 deteriorated and one had an amputation. CONCLUSIONS: One year following FFB, at least 18.0% of patients were dead. Among possible survivors to 1-year, graft patency was at least 78.8% and at least 75.8% remained clinically improved. FFB is effective in the treatment of unilateral iliac artery occlusion. LSV is as effective as a synthetic conduit.
Authors:
Mahesh Pai; Ashok Handa; Linda Hands; Jack Collin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  85     ISSN:  0035-8843     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-21     Completed Date:  2003-05-23     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  88-90     Citation Subset:  IM    
Affiliation:
Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Oxford, UK. m.pai@ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Arterial Occlusive Diseases / surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / methods*
Female
Femoral Artery / surgery*
Follow-Up Studies
Graft Survival
Humans
Iliac Artery*
Intermittent Claudication / surgery
Ischemia / surgery
Leg / blood supply
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Ultrasonography, Doppler
Vascular Patency

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


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