The role of composite sequential bypass in the treatment of multilevel infrainguinal arterial occlusive disease
| Autor: | Joel P. Yuhas, Joseph J. Piotrowski, J.Jeffrey Alexander, Kip E. Wells |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Prosthetic graft Occlusive disease Arterial Occlusive Diseases Arterial reconstruction Internal medicine medicine Humans Vascular Patency Life Tables Popliteal Artery Secondary vein Vein Retrospective Studies Leg Graft patency business.industry Retrospective cohort study General Medicine Blood Vessel Prosthesis Surgery Femoral Artery Tibial Arteries Treatment Outcome medicine.anatomical_structure Cardiology business Vascular Surgical Procedures |
| Zdroj: | The American Journal of Surgery. 172:118-122 |
| ISSN: | 0002-9610 |
| Popis: | BACKGROUND : In this study, the efficacy of composite sequential bypass is compared to that of standard in situ bypass, and to alternate prosthetic graft systems which have been used for the treatment of multilevel infrainguinal arterial occlusive disease in the absence of suitable autogenous vein. PATIENTS AND METHODS : A retrospective review of graft patency and limb salvage included 197 patients undergoing 211 bypass procedures consisting of in situ femoral-tibial (IS ; n = 119) ; composite sequential (CS ; n = 35), prosthetic femoropopliteal with single (PFP-1 ; n = 30) or no vessel runoff (PFP-O ; n = 9), and prosthetic femoral-tibial (PFT ; n = 18) bypass. RESULTS : By life-table analysis, IS bypass provided superior primary (P < 0.005) and secondary (P < 0.0005) patency over the other groups. CS bypass was similar to PFP-1, with a 2-two year primary patency of 35% and 44% (NS), respectively, and limb salvage rates of 60% and 80% (P = 0.01). PFP-O and PFT bypass procedures did considerably worse, with a 1-year patency of 19% and 22%, respectively, and associated limb salvage rates of 25% and 41% (NS). CONCLUSIONS : Composite sequential bypass is an acceptable procedure for infrainguinal arterial reconstruction when absence of autogenous vein prevents either in situ or secondary vein graft bypass procedures. |
| Databáze: | OpenAIRE |
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