title: [Femoro-distal revascularization for "critical" chronic atheromatous ischemia. 695 cases].
abstract: The results of the revascularizations carried out over a 10-year period for "critical" chronic ischaemia, using the femoropopliteal bypass technique, have been retrospectively analyzed. In all, 600 patients underwent femoro-distal revascularization in 644 limbs, and 695 bypasses were performed. The hospital mortality rate was 4.3 percent. Among these 695 bypasses, postoperative occlusion occurred in 16.5 percent of the cases, and major amputations were necessary in 9.8 percent. The probability of 5-year survival was 47 percent. The probabilities of bypass patency and limb salvage were 50 and 76 percent respectively. The failure of revascularization ending in amputation did not significantly increase the postoperative mortality rate (4.1 percent versus 4.6 percent), but the life expectancy of patients who were amputated was significantly lower than that of patients who were not (55 +/- 5 percent versus 63 +/- 3 percent at 3 years; P = 0.03). The factors predictive of successful bypass were examined; they included age, clinical stage, diabetes, bypass material, site of distal implantation, revascularization procedure and reoperation. Femoro-distal revascularization makes it possible to cope with the challenge of limb salvage, even when the receiving vessel is an artery of the foot.
authors.affiliation: Service de Chirurgie vasculaire, Hôpital Saint-Joseph, Paris.
authors.forename: J
authors.initials: J
authors.lastname: Marzelle
authors.forename: J M
authors.initials: JM
authors.lastname: Fichelle
authors.forename: G
authors.initials: G
authors.lastname: Alimi
authors.forename: J M
authors.initials: JM
authors.lastname: Grüss
authors.forename: F
authors.initials: F
authors.lastname: Cormier
authors.forename: F
authors.initials: F
authors.lastname: Gigou
authors.forename: B
authors.initials: B
authors.lastname: Artru
authors.forename: C
authors.initials: C
authors.lastname: Laurian
authors.forename: J M
authors.initials: JM
authors.lastname: Cormier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000714:Anastomosis, Surgical; D000800:Angioplasty, Balloon; D001161:Arteriosclerosis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D002908:Chronic Disease; D003327:Coronary Disease / Q000150:complications; D003925:Diabetic Angiopathies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D016909:Tibial Arteries / Q000000981:diagnostic imaging / Q000601:surgery
vernacular_title: Revascularisations fémoro-distales pour ischémie chronique "critique" d'origine athéromateuse. 695 observations.