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Titolo:
MANAGEMENT OF THE FAILED PRIMARY INFRAINGUINAL RECONSTRUCTION - TREATMENT OPTIONS AND LONG-TERM OUTCOME
Autore:
AKERS DL; HEWITT RL;
Indirizzi:
TULANE UNIV,DEPT SURG,1430 TULANE AVE NEW ORLEANS LA 70112
Titolo Testata:
Vascular surgery
fascicolo: 4, volume: 30, anno: 1996,
pagine: 281 - 288
SICI:
0042-2835(1996)30:4<281:MOTFPI>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOWER-EXTREMITY ISCHEMIA; INSITU SAPHENOUS-VEIN; AUTOGENOUS VEIN; POLYTETRAFLUOROETHYLENE GRAFTS; BYPASS; REVASCULARIZATION; EXPERIENCE; FAILURES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
D.L. Akers e R.L. Hewitt, "MANAGEMENT OF THE FAILED PRIMARY INFRAINGUINAL RECONSTRUCTION - TREATMENT OPTIONS AND LONG-TERM OUTCOME", Vascular surgery, 30(4), 1996, pp. 281-288

Abstract

Patients presenting with critical limb ischemia following failed infrainguinal grafts have been reported to have a significant amputation rate and reduced long-term survival. The authors reviewed their three-year experience with 33 patients with failed infrainguinal reconstruction. The median age was 63.1 years of age (range forty-three to eighty-seven years). There were 19 women and 14 men. Risk factors included the following: hypertension 31 (94%), diabetes 21 (64%), and tobacco use30 (91%). All patients had limb-threatening ischemia, 15 had gangrene(45.4%), 8 had ulceration (24.2%), and 10 had rest pain 10 (30.3%). There had been 42 previous revascularizations (1.27 per patient, range 1 to 6). The authors performed 45 revascularization operations (1.36 per patient, range 1 to 4). Inflow was as follows: common femoral artery in 29 (64.4%), superficial femoral artery in 9 (20%), profunda femoris in 4 (8.9%), aortobifemoral graft limb in 2 (4.4%), and femoral-femoral bypass graft in 1 (2.2%). Outflow was as follows: posterior tibial artery 12 (26.7%), peroneal artery in 17 (37.8%), anterior tibial artery in 7 (15.6%), popliteal artery in 5 (11.1%), and tibioperoneal trunk in 4 (8.9%). The conduits were as follows: great saphenous vein (GSV) from the opposite lower limb in 8 (17.8%), GSV/lesser saphenous vein (LSV) composites in 8 (17.8%), expanded polytetrafluoroethylene in (ePTFE) 5 (11.1%), LSV composite in 10 (22.2%), ePTFE/GSV composite in5 (11.1%), cadaveric vein in 2 (4.4%), superficial femoral vein/ePTFEcomposite in 2 (4.4%), endarterectomized superficial femoral artery/GSV composite in 1 (2.2%), GSV/upper limb vein composite in 1 (2.2%); and upper limb vein in 3 (6.7%). There was one perioperative death (2.2%). Six patients died during the follow-up period (74.1% survival). Limb salvage was obtained in 28 patients (83.1%). Cumulative secondary patency was 73.2% at three years. These results indicate that: (1) aggressive revascularization for failed infrainguinal grafts can result insignificant limb salvage, and (2) Long-term survival is common in this patient population.

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Documento generato il 04/12/20 alle ore 15:54:51