| Selection of patients with critical limb ischaemia for femorodistal vein bypass. | |
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MedLine Citation:
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PMID: 8513909 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: European journal of vascular surgery Volume: 7 ISSN: 0950-821X ISO Abbreviation: Eur J Vasc Surg Publication Date: 1993 May |
Date Detail:
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Created Date: 1993-07-20 Completed Date: 1993-07-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8709440 Medline TA: Eur J Vasc Surg Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 291-7 Citation Subset: IM |
Affiliation:
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Department of Surgery, Leicester Royal Infirmary, U.K. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Female Femoral Artery / surgery Follow-Up Studies Graft Occlusion, Vascular / mortality, surgery Humans Ischemia / mortality, surgery* Leg / blood supply* Male 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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