| Long-Term Results after Prosthetic
Bypass Surgery for Chronic Limb Ischemia |
| Masahiko Ikebuchi |
Toshihiko Tanabe |
Hiroaki Kuroda |
| Kimiyo Ono |
|
|
(Department of Cardiovascular Surgery, San-in Rosai
Hospital, Yonago, Japan)
|
We evaluated long-term results of
126 consecutive bypass surgeries for chronic limb ischemia including
54 aorto-femoral (AF), 26 femoro-femoral crossover (FF), 7 axillo-femoral
(AxF), and 39 femoro-above the knee poplitealiFPjbypasses. Patients
who had undergone FF bypasses were significantly older than those
who received AF bypasses (P<0.01). Preoperative ankle
brachial pressure indices (ABI) of the AxF and FF patients were
significantly lower than those of AF patients (P<0.05).
Compared with AF patients, the AxF and FF groups included significantly
higher percentages of Fontaine III and IV limbs treated by limb
salvage surgery (P<0.05). The cumulative graft patency
rates 5 years after AF, FF, and FP bypasses were 94.7%, 91.3%,
and 64.3%, respectively. In the FP group, patients with intermittent
claudication before surgery showed a 5-year graft patency rate
of 82.5%, while that in patients who underwent surgery for limb
salvage was 43.3%. The secondary graft patency rates 5 years
after AF, FF, and FP bypasses were 94.6%, 91.3%, and 83.3%, respectively.
All patients whose bypass grafts were occluded were male and
were smokers. Poor run-off and insufficient anticoagulation therapies
were also associated with graft occlusion. Two of the 12 patients
who developed graft occlusion underwent limb amputation.@
@Jpn. J. Cardiovasc. Surg. 31: 177-182 (2002) |
|
