Affiliation:
1. Vascular Surgery Unit, Broadgreen Hospital, Liverpool, UK
Abstract
Abstract
A consecutive series of 200 patients having aortofemoral bypass grafts were studied in order to determine the effect of femoropopliteal occlusive disease on the results and the role of concomitant femorodistal bypass. Bifurcated aortic grafts were used in 177 patients and unilateral aortofemoral grafts in 23 giving 377 limbs for study. Of the 377 limbs, 184 (49 per cent) had minimal femoropopliteal disease (Group 1), 24 (6·4 per cent) had a femoropopliteal stenosis (Group 2) and 169 (44·6 per cent) had complete femoropopliteal occlusion (Group 3). In Group 3 aortofemoral bypass was carried out alone in 106 cases (Group 3a): in the other 63 cases femorodistal bypass was carried out at the same time as aortoiliac reconstruction (Group 3b). The cumulative patency at 5 years for all aortofemoral grafts together was 91 per cent. However, that for grafts in Group 3a was only 65 per cent compared with 98 per cent for Groups 1 and 3b and 94 per cent for Group 2. The cumulative patency rate for grafts in Group 3a was significantly lower than for all other groups (P<0·001). The operative mortality for those patients who had concomitant aortofemoral and femorodistal grafts (Group 3b) did not differ significantly from that of any of the other groups (P > 0·1). Of the cases in Group 3a, 21 (26 per cent) required femoropopliteal reconstruction at a later date. The results indicate that in the presence of combined aortoiliac and femoropopliteal occlusive disease concomitant reconstruction of both arterial segments yields significantly better results than aortoiliac bypass alone.
Publisher
Oxford University Press (OUP)
Reference13 articles.
1. Natural history of nonstenotic, asymptomatic ulcerative lesions of the carotid artery—a further analysis;Dixon;Arch Surg,1982
2. Immediate and long-term results after prophylactic endarterectomy;Moore;Am J Surg,1979
3. The natural history of asymptomatic carotid disease in patients undergoing cardiovascular surgery;Barnes;Surgery,1981
4. Prognosis of asymptomatic ulcerating carotid lesions;Kroener;Arch Surg,1980
5. Carotid endarterectomy. Complications and preoperative assessment of risk;Sundt;Mayo Clin Proc,1975
Cited by
38 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献