| Flow measurement before and after papaverine injection in above-knee prosthetic femoropopliteal bypass. | |
| | |
MedLine Citation:
|
PMID: 16616228 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To investigate the value of intraoperative blood flow measurements on early and long-term patency of above-knee prosthetic femoropopliteal bypass. METHODS: Flow was measured with a transit time flowmeter before (basal flow) and after an intragraft injection of papaverine (papaverine flow) in 87 operations (86 patients) between January 1990 and December 2001. Sixty-one grafts were of polyester, and 26 were of polytetrafluoroethylene. The operations were done under epidural anesthesia. The preoperative angiographic run-off score and clinical risk factors were recorded. Patency rates were analyzed with the product limit method and compared with the log-rank test. Variables found to be near significantly related to patency rates (P < .1) were included in a multivariate analysis performed with the Cox proportional hazard model. RESULTS: Basal flow measurements were not related to patency. The 2- and 5-year patency rates for grafts with a papaverine flow < or = 500 mL/min were 48% and 18% compared with 66% and 52% for grafts with a papaverine flow > or = 500 mL/min. These differences were statistically significant (P = .012, hazard ratio, 2.6). Two- and 5-year patency rates for smokers vs nonsmokers were 44% and 18% vs 69% and 54%. The patency rates for patients with poor vs good run-off were 42% and 27% vs 66% and 31%. Smoking (P = .008, hazard ratio, 2.75) and poor run-off score (P = .009, hazard ratio, 2.38) were found to be independent risk factors for reduced patency rates. Poor run-off score did not correlate with low values of measured basal or papaverine flow. CONCLUSIONS: Papaverine flow of < or = 500 mL/min is associated with reduced mid- and long-term patency rates. Additional antithrombotic medication and frequent follow-up for these grafts should be considered. The inferior patency rates of smokers and patients with poor run-off indicate that prosthetic bypass is less suitable for these groups of patients. |
| | |
Authors:
|
Gustav Pedersen; Elin Laxdal; Svein Roar Amundsen; Einar Dregelid; Torbjørn Jonung; Thomas Nyheim; Steinar Aune |
Related Documents
:
|
7586418 - Noninvasive assessment of left internal mammary artery graft patency using transthoraci... 7323758 - The prognostic value of blood-flow measurements during construction of arteriovenous fi... 6452488 - Blood flow in small arteries after end-to-end and end-in-end anastomoses: an experiment... 16904678 - Importance of flow division on transition to turbulence within an arteriovenous graft. 19642088 - A comparison of the adc and t2 mapping in an assessment of blood-clot lysability. 3553018 - Massive transfusion. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter Volume: 43 ISSN: 0741-5214 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2006 Apr |
Date Detail:
|
Created Date: 2006-04-17 Completed Date: 2006-05-17 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 729-34 Citation Subset: IM |
Affiliation:
|
Department of Surgery, Haukeland University Hospital, Bergen, Norway. gustav.pedersen@helse-bergen.no |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angiography Arterial Occlusive Diseases / radiography, surgery* Blood Flow Velocity / physiology Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation / adverse effects, methods* Cohort Studies Female Femoral Artery / surgery* Follow-Up Studies Humans Injections, Intralesional Male Monitoring, Intraoperative Papaverine / therapeutic use* Popliteal Artery / surgery* Probability Proportional Hazards Models Prosthesis Design Prosthesis Failure Retrospective Studies Risk Assessment Severity of Illness Index Treatment Outcome Vascular Patency / drug effects |
| Chemical | |
Reg. No./Substance:
|
58-74-2/Papaverine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Vocal cord paralysis after aortic arch surgery: predictors and clinical outcome.
Next Document: Revascularization for peripheral vascular disease in Aboriginal and non-Aboriginal patients.