Document Detail


Is infrapopliteal bypass compromised by distal origin of the proximal anastomosis?
MedLine Citation:
PMID:  7786703     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T E Brothers; J G Robison; B M Elliott; C Arens
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  9     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-07-27     Completed Date:  1995-07-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  172-8     Citation Subset:  IM    
Affiliation:
Medical University of South Carolina, Charleston, USA.
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MeSH Terms
Descriptor/Qualifier:
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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