Document Detail

Long-term follow-up of patients having infrainguinal bypass performed below stenotic but hemodynamically normal aortoiliac vessels.
MedLine Citation:
PMID:  3820404     Owner:  NLM     Status:  MEDLINE    
Because infrainguinal bypasses performed on the basis of normal papaverine testing in patients with multilevel arterial occlusive disease are done below arteriographically diseased although hemodynamically normal vessels, there is concern about progression of suprainguinal disease compromising long-term success. This study has been done to assess the long-term results of such bypasses. Between 1979 and 1985, infrainguinal bypasses selected by papaverine testing were done on 92 limbs having hemodynamically normal inflow in the presence of arteriographically demonstrable aortoiliac stenoses of 15% to 70%. Long-term hemodynamic and clinical success rates were determined with criteria based on papaverine and noninvasive vascular testing. There was no significant difference in hemodynamic success at 48 months (by life-table analysis) (p = 0.98) when comparing limbs with less than 50% aortoiliac stenoses to limbs having 50% or greater stenoses. The difference between the mean degree of preoperative inflow stenoses for long-term hemodynamic successes (32.5% +/- 1.5%) and failures (34.6% +/- 3.0%) was not significant (p = 0.57). There was no significant difference (p = 0.98) in the number of subsequent inflow procedures required in limbs with preoperative aortoiliac stenoses of less than 50% (13.5%) vs. aortoiliac stenoses of 50% or greater (13.3%). Long-term results of infrainguinal bypass done below stenotic but hemodynamically normal aortoiliac vessels are not related to the amount of angiographically demonstrable inflow stenosis. Selection of patients for infrainguinal bypass on the basis of papaverine testing, irrespective of angiographic findings, eliminates unnecessary inflow procedures without detriment to long-term success.
M J Kikta; D P Flanigan; R A Bishara; S F Goodson; J J Schuler; J P Meyer
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  5     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1987 Feb 
Date Detail:
Created Date:  1987-03-30     Completed Date:  1987-03-30     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  319-28     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Aorta, Abdominal* / physiology
Arterial Occlusive Diseases / complications*,  diagnosis,  radiography
Bioprosthesis* / adverse effects
Blood Vessel Prosthesis* / adverse effects
Femoral Artery / surgery
Follow-Up Studies
Iliac Artery* / physiology
Leg / blood supply*
Middle Aged
Papaverine / diagnostic use
Popliteal Artery / surgery
Saphenous Vein / surgery,  transplantation
Time Factors
Reg. No./Substance:
0/Fluorocarbons; 116-14-3/tetrafluoroethylene; 58-74-2/Papaverine

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

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