Peroneal artery bypass: a multifactorial analysis.
Sixty-two bypass grafts to the peroneal artery were performed at the University of Rochester Medical Center between 1984 and 1990. An autogenous conduit was used in 45 patients and a prosthetic conduit in 17 patients. Primary cumulative patency rates were 49% at two years and 30% at four years following operation. Limb salvage was achieved in 68% of patients. The two year cumulative patency rate was significantly better when the peroneal artery was of good quality arteriographically compared with those in which stenoses were present (75% versus 25%, p less than 0.05); in patients without inflow disease compared with patients with inflow disease (56% versus 11%, p less than 0.05); and in saphenous vein grafts compared with prosthetic grafts (55% versus 17%, p less than 0.05). The factors that did not influence patency were the presence of a direct peroneal collateral vessel filling a pedal vessel, age, sex, diabetes, and the size of the peroneal artery. The results of peroneal artery bypass in end-stage patients are dependent on the presence of adequate autogenous vein and a recipient peroneal vessel free of disease. Under these circumstances, the results of the procedure approach that of standard femorotibial reconstruction.
Shortell
C K
CK
Division of Vascular Surgery, University of Rochester Medical Center, New York.
Ouriel
K
K
DeWeese
J A
JA
Green
R M
RM
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001166:Arteriovenous Shunt, Surgical / Q000379:methods / Q000706:statistics & numerical data*; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data; D005260:Female; D005734:Gangrene / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply*; D007871:Leg Ulcer / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D014654:Vascular Patency