Document Detail


Indications and benefits of simultaneous endoluminal balloon angioplasty and open surgery during elective lower limb revascularization.
MedLine Citation:
PMID:  10353679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Combined balloon angioplasty and conventional revascularization are occasionally performed but some points are still controversial: which patients are eligible for this associated procedure?; should the procedures be performed simultaneously or successively?; and in case of simultaneous procedure, which one should be performed first? To answer these questions, the notes of 64 patients consecutively submitted to this procedure at the Henri Mondor hospital were reviewed. Arterial dilatation was performed on the iliac artery, superficial femoral artery, popliteal artery or tibioperoneal trunk in 31, 26, four and four patients, respectively. Reasons for simultaneous procedures were multiple occlusive lesions in 67% of patients and inflow improvement in 14%. The others reasons included iliac obstruction in poor risk patients, unilateral failure of planned bilateral iliac balloon angioplasty, outflow improvement, local contraindication to arterial approach, shortness of vein graft, clamp injury during open surgery and inadequate patient position for both procedures. Complications were rare. One patient died of recurrent sepsis of the femoro-femoral bypass. The 5-year limb salvage rate was 91%. In this study, simultaneous procedures were associated with three advantages: the risk of septic complications associated with graft implantations in a previously punctured site was decreased, anticoagulant and/or antiplatelet therapy did not need to be modified before the second procedure, hospital length of stay and cost appeared to be lower. On a simultaneous procedure, it is recommended that the balloon angioplasty be performed after the conventional procedure in order to avoid clamping a recently dilated artery when performing the bypass.
Authors:
D Melliere; J Cron; E Allaire; P Desgranges; J P Becquemin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  7     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-08     Completed Date:  1999-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  242-6     Citation Subset:  IM    
Affiliation:
Vascular Surgery Unit of Henri Mondor Hospital, Paris-Val de Marne University, Créteil, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon*
Arterial Occlusive Diseases / surgery,  therapy*
Blood Vessel Prosthesis Implantation*
Female
Femoral Artery / surgery
Humans
Intermittent Claudication / surgery
Leg / blood supply*
Male
Middle Aged
Polytetrafluoroethylene
Popliteal Artery / surgery
Retrospective Studies
Chemical
Reg. No./Substance:
9002-84-0/Polytetrafluoroethylene

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


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