| Vein bypasses to branches of pedal arteries. | |
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MedLine Citation:
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PMID: 22209614 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: We report a retrospective analysis of our experience in bypass vein graft surgery to lateral tarsal, medial plantar, and lateral plantar arteries for treatment of critical limb ischemia (CLI). METHODS: Between January 1991 and February 2010, we performed 137 inframalleolar bypass graft surgeries; of these, 25 (18%) were conducted using foot branch arteries for distal implant. All patients were treated for CLI and most had extensive infrapopliteal atherosclerotic disease (TransAtlantic Inter-Society Consensus D). Mean follow-up was 46.32 months (range, 0-144 months). Main end points analyzed were cumulative patency, limb salvage, and survival. Statistic analysis of all end points was performed using Kaplan-Meier survival curves. RESULTS: There was a predominance of men (64%), and the group mean age was 66.3 years. Diabetes mellitus was the main associated disease. Eighty percent of ulcers or gangrene were restricted to the midfoot (Rutherford V CLI classification). There was a predominance of short-length grafts using the great saphenous vein as the main conduit (72%). The medial plantar artery was the main outflow artery (52%). Early graft occlusion occurred in four patients (primary failure rate, 16%). Secondary patency at 1 and 3 years was 49% and 36.8%, respectively, and limb salvage was 81.7% and 69%, respectively. Nine major amputations occurred, and 10 other minor amputations were necessary. Survival rate at 3 years was 65.4%, and 67% of patients maintained ambulation. Surgical mortality was 8%. No condition was associated with worse results with regard to secondary patency, limb salvage, or survival. CONCLUSIONS: Long-term results for developed foot branch bypass demonstrated good results for limb salvage, and it is an acceptable surgery for patients with extensive atherosclerotic disease. |
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Authors:
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Francisco Cardoso Brochado-Neto; Marcus Vinícius Martins Cury; Suellen Stevam Timotheo Bonadiman; Marcelo Fernando Matielo; Sérgio Roberto Tiossi; Marcos Roberto Godoy; Katsumi Nakano; Roberto Sacilotto |
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Publication Detail:
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Type: Journal Article Date: 2011-12-30 |
Journal Detail:
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Title: Journal of vascular surgery Volume: 55 ISSN: 1097-6809 ISO Abbreviation: J. Vasc. Surg. Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-02-28 Completed Date: 2012-05-01 Revised Date: 2012-10-03 |
Medline Journal Info:
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Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 746-52 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Vascular Surgery, Hospital Servidor Publico Estadual, São Paulo, SP, Brazil. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Amputation Arteries / physiopathology, surgery Atherosclerosis / mortality, physiopathology, radiography, surgery* Brazil Chi-Square Distribution Critical Illness Female Graft Occlusion, Vascular / etiology, physiopathology, surgery Humans Ischemia / mortality, physiopathology, radiography, surgery* Kaplan-Meier Estimate Limb Salvage Lower Extremity / blood supply* Male Middle Aged Proportional Hazards Models Reoperation Retrospective Studies Risk Assessment Risk Factors Saphenous Vein / transplantation Survival Rate Time Factors Treatment Outcome Vascular Grafting* / adverse effects, mortality Vascular Patency |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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