[Indication and results of surgical treatment of intermittent claudication].
In order to clarify the propriety of surgical treatment for intermittent claudication caused by arteriosclerosis obliterans (ASO), indication for vascular reconstruction and efficacy of surgery on patient's quality of life were investigated. Bypass surgery or laser angioplasty (PTLA) was undertaken in 149 of 188 ASO patients. Because of high risk factors (renal failure, ischemic heart disease, cerebro-vascular disturbance or malignant tumor), 39 patients were treated conservatively. Intellectual dysfunction in aged patient was evaluated by Okabe's brief mental scale test. Coronary artery disease was revealed by coronary angiography performed next to routine dipyridamole-loaded ECG in 19 to 78 patients. CABG or PTCA was performed prior to peripheral vascular reconstruction in 3 patients with serious coronary disease. Extra-anatomical bypass or PTLA was indicated mainly in patients with coronary artery disease or intellectual dysfunction. The anatomical bypass and the extra-anatomical bypass were undertaken in 88 and 61 patients respectively. Graft occlusion was observed in 8 cases. Patency rate of the anatomical bypass was 96.6% and that of the extra-anatomical bypass was 91.8%, at 32 months of postoperative mean follow-up period. The operative mortality rate was 2.7%. There was no major amputation due to graft occlusion.
Ishimaru
S
S
Department of Surgery, Tokyo Medical College, Japan.
Shimizu
T
T
Yamazaki
T
T
Furukawa
K
K
D000368:Aged; D017130:Angioplasty / Q000401:mortality; D001162:Arteriosclerosis Obliterans / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014654:Vascular Patency