[In situ femoro-popliteal bypass grafts. Study of 85 cases using Cartier's technique].
From January 1985 to december 1989, 83 patients (69 men, 14 women) underwent an in situ femoro-popliteal bypass using a semi-closed technique and the valvulotome developed by Dr Paul Cartier. Most patients (67%) were operated for severe ischemia while 33% were for claudication. HTA was present in 31% of patients, diabetes in 38% and CAD in 57%. Mean preoperative ABI was 0.33 +/- 0.20 and mean ankle pressure was 50 +/- 30 mm of Hg. Arteriographic popliteal run-off showed three vessels in 21 cases (25%), two vessels in 17 cases (20%) and one vessel in 38 cases (45%). Nine patients (10%) presented an isolated popliteal artery. Bypass was constructed below knee in 62 patients (73%) and above knee in 23 (27%). Five mortalities (5.8%) and two major complications (2.3%) were related to surgery. Four early graft failures (4.4%) were noted but 3 were successfully reoperated. Postoperative ABI was 0.71 +/- 0.23 mm of Hg and 81% of patients had complete relief of their symptoms. With a mean follow-up 19 months, graft patency was 91% +/- 6% and 84% +/- 11% at one and two years and was not influenced by operative indication: hypertension, diabetes, preoperative ABI, arteriographic findings or distal anastomotic site. Overall survival was 80% +/- 10% and 69 +/- 13 at one and two years. The in situ technique using the Cartier valvulotomes is an excellent operation and compares favourably with other techniques.
Chapleau
D
D
Service de Chirurgie Vasculaire, Hôpital Maisonneuve-Rosemont, Montréal, Québec.
Lassonde
J
J
Blair
J F
JF
Laurendeau
F
F
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007383:Intermittent Claudication / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011183:Postoperative Complications; D012307:Risk Factors; D012501:Saphenous Vein / Q000601:surgery
Le pontage fémoro-poplité in situ. Etude de 85 cas opérés d'après la technique de Cartier.