| Infrainguinal reconstructions: influence of surgical experience on outcome. | |
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MedLine Citation:
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PMID: 9725513 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate the influence of surgical experience and operation technique on the outcome of infrainguinal reconstructions. DESIGN: A longitudinal observational study of patients undergoing reconstructions to the popliteal and crural arteries. SETTING: A regional hospital and an academic referral centre. MATERIALS: 392 patients undergoing 442 reconstructions, 218 to the popliteal and 228 to the crural vessels. Chief outcome measures: Graft patency and leg salvage. MAIN RESULTS: At the popliteal level, 5-year patency after autogenous vein reconstruction was 76%. No difference was found between in situ and transposed vein reconstructions, but prosthetic reconstructions had a worse patency. At the crural level, 5-year patency for in situ vein, transposed vein and prosthetic bypass were 66, 55 and 21%, respectively. Corresponding leg salvage for chronic critical leg ischaemia was 91% with vein and 55% with prosthetic reconstruction at popliteal level, and 66 and 33% at the crural level. Surgical experience improved the outcome, as 3-year patency for in situ and transposed vein bypasses to the popliteal level were 82 and 95% for experienced surgeons, and 53 and 75% for less experienced surgeons. Corresponding leg salvage rates for reconstructions to the popliteal and crural levels were 85 and 67% for experienced surgeons, and 61 and 52% for less experienced surgeons. CONCLUSIONS: Outcome of infrainguinal reconstructions is influenced by the reconstruction level. Surgical experience and choice of the appropriate reconstruction technique can improve outcome. |
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Authors:
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M Luther; M Lepäntalo |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular surgery (London, England) Volume: 6 ISSN: 0967-2109 ISO Abbreviation: Cardiovasc Surg Publication Date: 1998 Aug |
Date Detail:
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Created Date: 1998-11-09 Completed Date: 1998-11-09 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9308765 Medline TA: Cardiovasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 351-7 Citation Subset: IM |
Affiliation:
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Vasa Central Hospital, Surgical Department, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anastomosis, Surgical Blood Vessel Prosthesis Implantation* Clinical Competence* Diabetic Angiopathies / surgery Female Humans Ischemia / surgery* Leg / blood supply* Longitudinal Studies Male Popliteal Artery / surgery* Treatment Outcome Vascular Patency Veins / transplantation* |
| Comments/Corrections | |
Comment In:
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Cardiovasc Surg. 1999 Apr;7(3):386-8
[PMID:
10386763
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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