Twenty-year experience in vein bypasses to branches of pedal arteries.

Twenty-year experience in vein bypasses to branches of pedal arteries.

MedLine Citation:	PMID: 22209614 Owner: NLM Status: Publisher
Abstract/OtherAbstract:	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.

Authors:	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
Related Documents :	6331824 - Control of bleeding in extrahepatic portal hypertension--the reverse splenorenal shunt ... 8187134 - Spontaneous aneurysmal intrahepatic portosystemic venous shunt. 6860914 - Adjuvant distal arteriovenous shunt with femorotibial bypass for critical ischaemia. 16470874 - Assessment of alaryngeal speech using a sound-producing voice prosthesis in relation to... 9602654 - Self expandable stents for relief of venous baffle obstruction after the mustard operat... 18214594 - Biocompatibility and recanalization characteristics of hydrogel microspheres with polyz...
Publication Detail:	Type: JOURNAL ARTICLE Date: 2011-12-29
Journal Detail:	Title: Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter Volume: - ISSN: 1097-6809 ISO Abbreviation: - Publication Date: 2011 Dec
Date Detail:	Created Date: 2012-1-2 Completed Date: - Revised Date: -
Medline Journal Info:	Nlm Unique ID: 8407742 Medline TA: J Vasc Surg Country: -
Other Details:	Languages: ENG Pagination: - Citation Subset: -
Copyright Information:	Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:	Department of Vascular Surgery, Hospital Servidor Publico Estadual, São Paulo, SP, Brazil.
Export Citation:	APA/MLA Format Download EndNote Download BibTex
MeSH Terms
Descriptor/Qualifier:

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

Previous Document: Predictive factors for mortality after open repair of paravisceral abdominal aortic aneurysm.
Next Document: Endothelium-dependent nitric oxide and hyperpolarization-mediated venous relaxation pathways in rat ...