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Titolo:
Tibial bypass using complex autologous conduit: Patency and limb salvage
Autore:
Halloran, BG; Lilly, MP; Cohn, EJ; Benjamin, ME; Flinn, WR;
Indirizzi:
Univ Maryland, Sch Med, Div Vasc Surg, Baltimore, MD 21201 USA Univ Maryland Baltimore MD USA 21201 v Vasc Surg, Baltimore, MD 21201 USA
Titolo Testata:
ANNALS OF VASCULAR SURGERY
fascicolo: 6, volume: 15, anno: 2001,
pagine: 634 - 643
SICI:
0890-5096(200111)15:6<634:TBUCAC>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
INSITU SAPHENOUS-VEIN; LOWER-EXTREMITY REVASCULARIZATION; PRIMARY FEMOROPOPLITEAL BYPASS; COMPOSITE SEQUENTIAL BYPASS; POLYTETRAFLUOROETHYLENE GRAFTS; ARTERIAL RECONSTRUCTION; ARM VEIN; INFRAINGUINAL RECONSTRUCTION; INTERPOSITION CUFFS; AUTOGENOUS VEIN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
49
Recensione:
Indirizzi per estratti:
Indirizzo: Lilly, MP Univ Maryland Hosp, Div Vasc Surg, 22 S Greene St, Baltimore, MD21201 USA Univ Maryland Hosp 22 S Greene St Baltimore MD USA 21201 201 USA
Citazione:
B.G. Halloran et al., "Tibial bypass using complex autologous conduit: Patency and limb salvage", ANN VASC S, 15(6), 2001, pp. 634-643

Abstract

Over an 8-year period, we performed 93 lower extremity bypasses using complex autologous conduits, which included (1) contralateral greater saphenousvein (GSV), (2) composite GSV, (3) superficial femoral vein, (4) lesser saphenous vein, (5) cephalic or basilic veins, and (6) composite-sequential (PTFE and vein) grafts. These grafts represented 16% of all infrainguinal bypasses during this period, and all grafts were performed to treat limb-threatening ischemia. Survival, patency, and limb salvage were examined by the life-table method. Primary graft patency was 46 and 38% at 3 and 5 years. Assisted-primary patency was 62 and 59%, and secondary graft patency rates were 68 and 64% at 3 and 5 years. Twenty-nine bypasses (31%) required revision to restore or maintain patency. The 3-year limb salvage rate was significantly better when revision was performed for graft stenosis than for graftthrombosis (90% vs. 46%, p <0.05). Overall limb salvage rate was 73% at 5 years. The mortality rate was 5.4% and the 5-year survival was 51%. Complexautologous tibial bypasses provided acceptable long-term limb salvage in patients with severe ischemia and inadequate ipsilateral GSV. The increased operating time and complexity required did not produce prohibitive operative risks. Postoperative graft surveillance in these complex vein bypasses allowed revision in many cases before graft occlusion occurred and significantly improved long-term limb salvage.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/12/20 alle ore 20:22:40