Document Detail

Is infrainguinal bypass grafting successful following failed angioplasty?
MedLine Citation:
PMID:  17408992     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Angioplasty is often used in the management of lower limb ischaemia and can reduce the need for infrainguinal bypass in some patients. There is an associated failure rate with this technique and bypass surgery is often used in this situation as a secondary limb salvage procedure. We aimed to evaluate the outcome of infrainguinal bypass grafting following failed attempt at angioplasty. METHODS: All cases of infrainguinal bypass at a single centre over a seven year period were identified and notes reviewed. Cases were divided into four groups according to their indication for surgery; acute ischaemia, chronic critical ischaemia, failed angioplasty and an 'other' group including aneurysmal disease and claudicants. The failed angioplasty group was compared with the other three groups. Survival analysis was performed using Kaplan Meier curves and groups compared in terms of long term patency and survival. RESULTS: Primary patency was 61.2% in the failed angioplasty group at 12 months compared with 60.6% in the other groups (P=1.11). There was also no significant difference in primary patency at 60 months (50% vs 40.6%, P=0.26). Survival at 12 months was also comparable between the groups (failed angioplasty group 74.2% compared with 77.3% in the other groups, P=0.662) as was 60 months survival (33.3% and 35.4% respectively, P=0.166). DISCUSSION: In this study, outcome of infrainguinal bypass following failed angioplasty was comparable to outcome of surgery performed for another indication. This paper supports the use of distal bypass surgery for limb salvage in cases where minimal access techniques have failed.
R M Sandford; M J Bown; R D Sayers; J N London; A R Naylor; M J McCarthy
Publication Detail:
Type:  Journal Article     Date:  2007-04-03
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  34     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-11     Completed Date:  2007-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  29-34     Citation Subset:  IM    
Vascular Surgery group, Department of Cardiovascular Sciences, University of Leicester, Level 2 RKCSB, Leicester Royal Infirmary, Leicester LE2 7LX, UK.
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MeSH Terms
Aged, 80 and over
Angioplasty / adverse effects*
Blood Vessel Prosthesis Implantation / methods*
Femoral Artery / surgery*,  ultrasonography
Follow-Up Studies
Inguinal Canal
Middle Aged
Peripheral Vascular Diseases / physiopathology,  therapy*,  ultrasonography
Popliteal Artery / surgery*,  ultrasonography
Retrospective Studies
Treatment Failure
Ultrasonography, Doppler, Duplex
Vascular Patency / physiology

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