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Titolo:
ARE FEMORO-INFRAPOPLITEAL BYPASSES WORTHWHILE FOR LIMB SALVAGE
Autore:
CAVILLON A; MELLIERE D; ALLAIRE E; BLANCAS AE; BERRAHAL D; DESGRANGES P; BECQUEMIN JP;
Indirizzi:
HOP HENRI MONDOR,SERV CHIRURG VASC F-94010 CRETEIL FRANCE UNIV PARIS 12,DEPT VASC SURG PARIS FRANCE
Titolo Testata:
Journal of Cardiovascular Surgery
fascicolo: 3, volume: 39, anno: 1998,
pagine: 267 - 272
SICI:
0021-9509(1998)39:3<267:AFBWFL>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
SAPHENOUS-VEIN; POLYTETRAFLUOROETHYLENE GRAFTS; ARTERIAL RECONSTRUCTION; ARTERIOVENOUS-FISTULA; INFRAINGUINAL BYPASS; AUTOGENOUS VEIN; PATENCY; ISCHEMIA; REVASCULARIZATION; EXPERIENCE;
Keywords:
FEMORAL ARTERY SURGERY; POPLITEAL ARTERY SURGERY; ISCHEMIA SURGERY; LEG BLOOD SUPPLY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
38
Recensione:
Indirizzi per estratti:
Citazione:
A. Cavillon et al., "ARE FEMORO-INFRAPOPLITEAL BYPASSES WORTHWHILE FOR LIMB SALVAGE", Journal of Cardiovascular Surgery, 39(3), 1998, pp. 267-272

Abstract

Objective. This study was performed in order to determine if: 1- femoral bypasses ending below the popliteal artery are justified in aged patients or in patients with poor general conditions, 2- if the use of prosthetic material is justified when no vein is available, 3- if reintervention is beneficial in case of bypass occlusion, Experimental design. Retrospective study of 162 infrapopliteal bypasses followed during 1 to 12 years (mean: 1.5). Setting. Vascular Surgery Department of the University Hospital Henri Mondor based in a suburb of Paris, France. Patients, All patients who underwent a femoral bypass ending below the popliteal artery for Limb salvage from January 1984 to December 1995. Intervention. These bypasses were performed with a vein in 131 cases and with a PTFE graft (with or without distal cuff) in 31 cases. Measures. All patients were followed with clinical evaluation and duplex scan. Primary and secondary patency, limb salvage and patient survivalwere studied, The survival rates at 1 and 5 years were 87+/-3.8% and 66+/-9.6% respectively, Preoperative mortality was 7.4%. Renal insufficiency requiring dialysis, not age over 80, was associated with high perioperative mortality. Results. The primary patency rates of the total series at 1 and 5 years were 55 and 35% respectively for the total series. For venous bypasses, it was 58 and 37% while for prosthetic bypasses, it was 49 and 15%, The secondary patency rates at 1 and 5 yearswere 67 and 46% for the total series. For venous bypasses, it was 70 and 49% and for prosthetic bypasses, it was 53 and 21%. Limb salvage rates at 1 and 5 years were 65 and 61% for the total series, 73 and 65%for venous bypasses and 48 and 41% for prosthetic bypasses. Conclusion. 1- Femorotibial or peroneal bypasses are worthwhile for limb salvage even in aged patients but renal insufficiency requiring dialysis mayjustify primary amputation. 2- If no vein can be used, prosthetic or composite bypasses should be performed because they are associated with a 41% limb salvage rate at 5 years. 3- If thrombosis occurs, the increase of patency after re-operation is 12% in case of venous bypass and 6% in case of prosthetic bypass.

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Documento generato il 30/11/20 alle ore 16:41:55