| Is infrapopliteal bypass compromised by distal origin of the proximal anastomosis? | |
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MedLine Citation:
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PMID: 7786703 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Distal origination of the proximal anastomosis (DOPA) of an infrapopliteal bypass beyond the adductor hiatus minimizes the length of graft required and optimizes use of scarce autogenous conduit. Sixty-two DOPA infrapopliteal revascularizations using autogenous vein performed for limb salvage over a 7-year period were reviewed and compared with 203 concurrent infrapopliteal bypasses originating more proximally (POPA). Life-table analysis revealed no difference at 54 months between DOPA and POPA bypass with regard to primary patency (57% vs. 50%, respectively) or secondary patency (67% vs. 65%, respectively). Differences in limb salvage at 54 months between DOPA and POPA bypasses did not reach statistical significance (53% vs. 66%, p = 0.12), although DOPA fared worse. Inferior limb salvage results in all infrapopliteal bypasses were correlated with the presence of tissue necrosis (52% vs. 70%, p < 0.001), which was more prevalent in patients undergoing DOPA bypass (71% vs. 49%, p < 0.01). The long-term patency of infrapopliteal bypass appears only marginally affected by DOPA. However, the prognosis for limb salvage in this setting is compromised as a result of the virulent behavior of the atherosclerotic disease that spares the superficial femoral artery while predominantly involving the popliteal and tibial vessels. |
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Authors:
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T E Brothers; J G Robison; B M Elliott; C Arens |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Annals of vascular surgery Volume: 9 ISSN: 0890-5096 ISO Abbreviation: Ann Vasc Surg Publication Date: 1995 Mar |
Date Detail:
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Created Date: 1995-07-27 Completed Date: 1995-07-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 172-8 Citation Subset: IM |
Affiliation:
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Medical University of South Carolina, Charleston, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Anastomosis, Surgical / methods Chi-Square Distribution Female Humans Leg / blood supply* Life Tables Male Middle Aged Multivariate Analysis Popliteal Artery / surgery* Prognosis Proportional Hazards Models Survival Rate Vascular Patency Veins / transplantation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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