Document Detail

Selection of patients with critical limb ischaemia for femorodistal vein bypass.
MedLine Citation:
PMID:  8513909     Owner:  NLM     Status:  MEDLINE    
The merits of an aggressive policy of distal reconstruction have been questioned by some observers. To determine the factors affecting graft patency and mortality, we analysed 78 consecutive infragenicular femorodistal vein grafts performed in 72 patients with critical limb ischaemia. The primary, primary assisted and secondary graft patency rates at 36 months were 29, 57 and 64%, respectively. The limb salvage and patient survival rates at 36 months were 67 and 74%, respectively. Univariate analysis (log-rank test) was performed to identify factors affecting graft patency, limb salvage and mortality at 1 month (perioperative) and 1 year. Independent variables of age, sex, diabetes, presentation, level of anastomosis and vein technique (reversed or in situ) did not affect graft patency. The ankle systolic pressure did not predict graft patency but was an independent variable affecting mortality (p = 0.047), as did diabetes (p = 0.019). These results show that excellent limb salvage can be successfully achieved in severely ischaemic patients by adopting an aggressive approach to femorodistal bypass, and that age, gender and poor medical condition are not contraindications to femorodistal bypass. The difference between the primary and primary assisted patency rates in this series is dramatic and reflects the impact of a vein graft surveillance programme in preventing graft occlusion.
R D Sayers; M M Thompson; N J London; K Varty; A R Naylor; J S Budd; D A Ratliff; P R Bell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular surgery     Volume:  7     ISSN:  0950-821X     ISO Abbreviation:  Eur J Vasc Surg     Publication Date:  1993 May 
Date Detail:
Created Date:  1993-07-20     Completed Date:  1993-07-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709440     Medline TA:  Eur J Vasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  291-7     Citation Subset:  IM    
Department of Surgery, Leicester Royal Infirmary, U.K.
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MeSH Terms
Aged, 80 and over
Femoral Artery / surgery
Follow-Up Studies
Graft Occlusion, Vascular / mortality,  surgery
Ischemia / mortality,  surgery*
Leg / blood supply*
Middle Aged
Popliteal Artery / surgery
Survival Rate
Tibial Arteries / surgery
Veins / transplantation*

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

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