| Preoperative angiographic score and intraoperative flow as predictors of the mid-term patency of infrapopliteal bypass grafts. | |
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MedLine Citation:
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PMID: 11112463 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: preoperative angiographic characteristics of the outflow tract have emerged as a predictive factor for the outcome of infrapopliteal reconstructions. Direct flow measurement can be routinely performed intraoperatively, but little is known regarding its impact on graft outcome. The present study was undertaken to compare the value of these parameters in predicting the mid-term patency of infrapopliteal bypass grafts. DESIGN: retrospective clinical study. PATIENTS: 172 infrapopliteal reconstructions using autogenous vein were performed, of which 92 had a crural and 80 a pedal recipient artery. METHODS: the preoperative angiogram was scored according to the SVS/ISCVS Ad Hoc Committee. At the end of the operation flow was measured with a transit-time flowmeter. Follow-up consisted of pressure measurements and duplex scanning. RESULTS: the runoff score had no impact on femorocrural graft patency. For pedal grafts there was a tendency for inferior outcome with high runoff score, as the 1-year assisted primary patency for grafts with a completely occluded pedal arch was 11% compared with 52% for grafts with lower scores (p=0.056). Both intraoperative volume graft flow and maximum flow capacity had a highly significant influence on the outcome on crural reconstructions on univariate analysis. For pedal reconstructions only a a severely reduced maximum flow capacity after injection of papaverin was associated with an adverse outcome. Multivariate analysis revealed that maximum flow capacity was an independent significant factor affecting patency of femoroinfrapopliteal grafts (relative risk=0.53 per 30 ml/min increase, p<0.001). The runoff score was also a weak independent predictor of 1-year assisted primary patency in these grafts (relative risk=1.9 for a score >4 in crural and a score >5.5 in pedal grafts, p=0.036). CONCLUSIONS: a completely occluded pedal arch in preoperative angiography was associated with poor infrapopliteal bypass outcome. Graft flow and maximal flow capacity are good predictors of the 1-year graft patency of femorocrural bypasses. |
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Authors:
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A Albäck; W D Roth; L Ihlberg; F Biancari; M Lepäntalo |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 20 ISSN: 1078-5884 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2000 Nov |
Date Detail:
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Created Date: 2001-02-09 Completed Date: 2001-02-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 447-53 Citation Subset: IM |
Copyright Information:
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Copyright 2000 Harcourt Publishers Ltd. |
Affiliation:
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Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Angiography* Arterial Occlusive Diseases / surgery* Blood Flow Velocity Female Humans Intraoperative Period Ischemia / surgery Leg / blood supply* Male Middle Aged Popliteal Artery / surgery* Preoperative Care Rheology Transplantation, Autologous Treatment Outcome Vascular Patency* Veins / transplantation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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