OBJECTIVE: to identify the risk factors affecting the outcome of bypass grafts to the foot arteries. DESIGN: longitudinal observational study from a single institution. MATERIALS AND METHODS: one-hundred and sixty-five infrainguinal bypasses to the foot arteries were performed in 162 legs of 149 patients with critical leg ischaemia. RESULTS: at 1-month, 1-year, 2-year and 3-year follow-up, the primary patency rates were 74%, 43%, 38% and 34%, the secondary patency rates were 82%, 50%, 47% and 41%, the leg salvage rates were 88%, 66%, 66% and 60%, survival rates were 95%, 76%, 69% and 55%, whereas 82%, 53%, 49% and 36% of patients were alive with salvaged leg, respectively. Low preoperative plasma concentrations of C-reactive protein (CRP) and short grafts with more distal arterial inflow had a better outcome. Better primary and secondary patency rates were also achieved by experienced surgeons and by the use of in situ saphenous vein grafts. Pedal run-off scoring did not have any impact on the outcome of pedal bypasses. CONCLUSIONS: short pedal bypasses using in situ saphenous vein technique, done by an experienced surgeon, have the best outcome. Revascularisation to the foot arteries may carry a poor outcome in patients with elevated preoperative CRP concentration. Copyright 1999 W.B. Saunders Company Ltd.
OBJECTIVE: to identify the risk factors affecting the outcome of bypass grafts to the foot arteries. DESIGN: longitudinal observational study from a single institution. MATERIALS AND METHODS: one-hundred and sixty-five infrainguinal bypasses to the foot arteries were performed in 162 legs of 149 patients with critical leg ischaemia. RESULTS: at 1-month, 1-year, 2-year and 3-year follow-up, the primary patency rates were 74%, 43%, 38% and 34%, the secondary patency rates were 82%, 50%, 47% and 41%, the leg salvage rates were 88%, 66%, 66% and 60%, survival rates were 95%, 76%, 69% and 55%, whereas 82%, 53%, 49% and 36% of patients were alive with salvaged leg, respectively. Low preoperative plasma concentrations of C-reactive protein (CRP) and short grafts with more distal arterial inflow had a better outcome. Better primary and secondary patency rates were also achieved by experienced surgeons and by the use of in situ saphenous vein grafts. Pedal run-off scoring did not have any impact on the outcome of pedal bypasses. CONCLUSIONS: short pedal bypasses using in situ saphenous vein technique, done by an experienced surgeon, have the best outcome. Revascularisation to the foot arteries may carry a poor outcome in patients with elevated preoperative CRP concentration. Copyright 1999 W.B. Saunders Company Ltd.
Authors: Jade S Hiramoto; Christopher D Owens; Ji Min Kim; John Boscardin; Michael Belkin; Mark A Creager; Michael S Conte Journal: J Vasc Surg Date: 2012-05-25 Impact factor: 4.268