M Luther1, M Lepäntalo. 1. Vasa Central Hospital, Surgical Department, Finland.
Abstract
OBJECTIVES: To analyse the influence of risk factors on the outcome of femorotibial reconstructions for chronic critical leg ischaemia. DESIGN: A longitudinal observational study of patients undergoing femorotibial reconstruction. SETTING: A regional hospital and an academic referral centre. MATERIALS: One hundred and eighty-eight patients undergoing 209 reconstructions to the tibial vessels for chronic critical leg ischaemia, 149 of them with in situ vein grafts. CHIEF OUTCOME MEASURES: Graft patency, leg salvage and survival rates. MAIN RESULTS: Severity of preoperative ischaemia influenced the immediate outcome of reconstruction. Increasing age did not influence graft patency, leg salvage or survival rates. A combination of female sex and diabetes was associated with low graft patency and leg salvage (52% and 42% at 18 months). Diabetes was associated with a decreased survival. CONCLUSIONS: With proper patient selection, patency and leg salvage rates in older (> 80 years) patient groups with multiple risk factors justify an active reconstruction policy.
OBJECTIVES: To analyse the influence of risk factors on the outcome of femorotibial reconstructions for chronic critical leg ischaemia. DESIGN: A longitudinal observational study of patients undergoing femorotibial reconstruction. SETTING: A regional hospital and an academic referral centre. MATERIALS: One hundred and eighty-eight patients undergoing 209 reconstructions to the tibial vessels for chronic critical leg ischaemia, 149 of them with in situ vein grafts. CHIEF OUTCOME MEASURES: Graft patency, leg salvage and survival rates. MAIN RESULTS: Severity of preoperative ischaemia influenced the immediate outcome of reconstruction. Increasing age did not influence graft patency, leg salvage or survival rates. A combination of female sex and diabetes was associated with low graft patency and leg salvage (52% and 42% at 18 months). Diabetes was associated with a decreased survival. CONCLUSIONS: With proper patient selection, patency and leg salvage rates in older (> 80 years) patient groups with multiple risk factors justify an active reconstruction policy.
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