Axillofemoral bypass: Outcome and hemodynamic results in high-risk patients
| Autor: | Joseph R. Schneider, Martha D. McDaniel, Jack L. Cronenwett, Daniel B. Walsh, Robert M. Zwolak |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
medicine.medical_specialty
Vascular disease business.industry General surgery Hemodynamics Aortoiliac occlusive disease The Renaissance Femoral artery Anastomosis medicine.disease Surgery Angina Concomitant medicine.artery Varicose veins medicine Derivation Varicose Ulcer medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Vascular Surgery. 15:0952-0963 |
| ISSN: | 0741-5214 |
| Popis: | Aortobifemoral bypass (AoFB) is the preferred method to provide lower extremity inflow. To determine whether axillofemoral bypass (AxFB) is an acceptable alternative for high-risk patients, we reviewed our results with these two operations. Between 1985 and 1990, 29 axillobifemoral and 5 axillounifemoral bypass procedures were performed preferentially because of severe associated medical illness in patients with severe aortoiliac occlusive disease. During the same interval, 107 patients received an AoFB for pure aortoiliac occlusive disease. Nearly all patients having AxFB and AoFB were heavy smokers, and the two groups had similar rates of hypertension and angina. However, other major risk factors were more frequently found in patients undergoing AxFB. Limb-threatening ischemia was more frequent and femoral artery occlusive disease was more severe in patients having AxFB. Anastomosis to the deep femoral arteries and concomitant infrainguinal bypass were more likely to be required in patients who had AxFB. Life-table patient survival at 3 years was 35% for AxFB versus 91% for AoFB ( p p = 0.032). Secondary patency was 74% for AxFB versus 94% for AoFB ( p p = 0.065). Nineteen of the 22 patients with AxFB who died during follow-up died with patent grafts. Hemodynamic performance of AxFB and AoFB were compared. Mean preoperative ankle-brachial index was higher in AoFB (0.50) than AxFB (0.38, p p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|