Document Detail


Quantitative assessment of outflow resistance in lower extremity arterial reconstructions.
MedLine Citation:
PMID:  6738049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Graft patency is thought to correlate with resistance in the runoff bed or outflow resistance. However, accurate measurement of this parameter has been difficult. A simple and reproducible method for direct measurement of outflow resistance following completion of the distal anastomosis of a bypass graft has been developed. This method employs injection of a fixed amount of normal saline through the proximal end of the graft and measurement of the resulting integrated pressure increment by an analog computer. Division of this pressure integral by the volume injected is a measure of the outflow resistance expressed in resistance units (mm Hg/ml/min). The median outflow resistance in 31 femoropopliteal bypasses was 0.29 units with a range of 0.08-1.38 units. The median outflow resistance in 33 femorodistal bypasses was 0.7 units with a range of 0.18-2.34 units. All bypasses with an outflow resistance of 1.1 units or less remained patent for 3 months. There were 51 grafts in this group (30 femoropopliteal; 21 femorodistal) and their outflow resistance ranged from 0.08 to 1.1 units. All bypasses with an outflow resistance of 1.2 units or higher thrombosed within the first postoperative month. There were 13 grafts in this group (1 femoropopliteal; 12 femorodistal) and their outflow resistance ranged from 1.2 to 2.38 units. Eight of the 13 grafts that failed originally were subjected to thrombectomy, which was uniformly unsuccessful. Although this method does not yet allow bypass surgery to be denied to any patient, it does define a group of patients in whom thrombectomy will not be effective and should not be attempted.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
E Ascer; F J Veith; L Morin; S A White-Flores; L A Scher; R H Samson; R K Weiser; S Rivers; S K Gupta
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of surgical research     Volume:  37     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  1984 Jul 
Date Detail:
Created Date:  1984-08-07     Completed Date:  1984-08-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  8-15     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography
Female
Femoral Artery / surgery
Graft Survival
Hemodynamics
Humans
Ischemia / surgery*
Leg / blood supply*
Male
Middle Aged
Popliteal Artery / surgery
Postoperative Complications
Prospective Studies
Regional Blood Flow
Thrombosis / etiology,  surgery
Vascular Resistance*

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


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