Vein bypasses to branches of pedal arteries.
J Vasc Surg
; 55(3): 746-52, 2012 Mar.
Article
en En
| MEDLINE
| ID: mdl-22209614
ABSTRACT
OBJECTIVE:
We report a retrospective analysis of our experience in bypass vein graft surgery to lateral tarsal, medial plantar, and lateral plantar arteries for treatment of critical limb ischemia (CLI).METHODS:
Between January 1991 and February 2010, we performed 137 inframalleolar bypass graft surgeries; of these, 25 (18%) were conducted using foot branch arteries for distal implant. All patients were treated for CLI and most had extensive infrapopliteal atherosclerotic disease (TransAtlantic Inter-Society Consensus D). Mean follow-up was 46.32 months (range, 0-144 months). Main end points analyzed were cumulative patency, limb salvage, and survival. Statistic analysis of all end points was performed using Kaplan-Meier survival curves.RESULTS:
There was a predominance of men (64%), and the group mean age was 66.3 years. Diabetes mellitus was the main associated disease. Eighty percent of ulcers or gangrene were restricted to the midfoot (Rutherford V CLI classification). There was a predominance of short-length grafts using the great saphenous vein as the main conduit (72%). The medial plantar artery was the main outflow artery (52%). Early graft occlusion occurred in four patients (primary failure rate, 16%). Secondary patency at 1 and 3 years was 49% and 36.8%, respectively, and limb salvage was 81.7% and 69%, respectively. Nine major amputations occurred, and 10 other minor amputations were necessary. Survival rate at 3 years was 65.4%, and 67% of patients maintained ambulation. Surgical mortality was 8%. No condition was associated with worse results with regard to secondary patency, limb salvage, or survival.CONCLUSIONS:
Long-term results for developed foot branch bypass demonstrated good results for limb salvage, and it is an acceptable surgery for patients with extensive atherosclerotic disease.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Extremidad Inferior
/
Aterosclerosis
/
Injerto Vascular
/
Isquemia
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged80
País/Región como asunto:
America do sul
/
Brasil
Idioma:
En
Revista:
J Vasc Surg
Asunto de la revista:
ANGIOLOGIA
Año:
2012
Tipo del documento:
Article
País de afiliación:
Brasil