Document Detail

Long-term outcome in patients under 40 years after revascularization for chronic lower limb ischaemia.
MedLine Citation:
PMID:  10532219     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In order to find out if surgical or endoluminal treatment changes the long-term results of atherosclerotic occlusive disease in patients of under 40 years of age we reviewed 17 consecutive patients. METHODS: Their mean age was 36.5. Patients with Buerger's disease or inflammatory arteriopathy were excluded. All patients were extremely heavy smokers. The indications for surgical procedures were disabling claudication (less than 100 meters) for 11 patients, rest pain for 4 patients and grangrene of a lower limb for 2 patients. The lesions were aorto-iliac in 12 cases and femoro-popliteal in 5. Ten surgical procedures were performed (5 aorto-femoral bypasses, 1 ilio-femoral bypass associated with an aorto-renal bypass, 2 femoropopliteal bypasses, 1 aorto-iliac endarteriectomy, 1 femoral endarteriectomy). On the other hand there were 7 endoluminal procedures (1 aortic, 4 iliac, 1 femoral and 1 popliteal). RESULTS: The mean follow-up was 97.3+/-50 months (range, from 34 to 216 months). Two patients died by 57 and 132 months respectively. At 5 years the survival rate was 94%; the primary patency rate was 59%; the secondary patency rate was 81% and the limb salvage rate was 94%. At 10 years these rates were respectively 94%, 44%, 54% and 75%. A total of 21 reoperations were performed. During follow-up 11 patients were better, 2 were stable and 4 were worse with 2 limbs lost. CONCLUSIONS: These bad results suggest keeping the surgical and endoluminal indications for patients younger than 40 years with threatened limbs.
P Bertrand; P Gouny; F Mercier; C Cheynel-Hocquet; V Duedal; O Nussaume
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  40     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  561-6     Citation Subset:  IM    
Department of Thoracic and Vascular Surgery, Tenon Hospital, Paris, France.
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MeSH Terms
Angioplasty, Balloon
Arteries / surgery
Arteriosclerosis / surgery*
Follow-Up Studies
Ischemia / surgery*
Leg / blood supply*
Treatment Outcome

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