Results of in-situ saphenous vein bypass to the foot.
To determine the efficacy of extending vascular reconstruction to the pedal vessels, the records of 115 in-situ saphenous vein bypasses to the infragenicular vessels were examined. Ninety-four percent were performed for limb-threatening ischemia and 6 percent for claudication. Ninety-one bypasses were to tibial vessels in the calf (Group 1), whereas severe disease of the tibial vessels in the calf necessitated bypass to arteries at the ankle and beyond in 24 (Group 2). Life-table analysis was used to calculate limb salvage, graft patency, and functional status for Group 1 and Group 2 36 months postoperatively; there were no statistical differences between groups with regard to these variables (p = 0.38). Diabetes had no impact on the success of reconstruction, and preoperative noninvasive testing was not predictive of graft failure in either group. Significantly, limb salvage closely paralleled graft patency and functional status, illustrating the severe disease in all patients. Patients with severe tibial-peroneal atherosclerosis may benefit from bypass grafting to the pedal arteries with a success rate equal to those done to more proximal sites.
Clifford
E J
EJ
University of Texas Southwestern Medical Center, Department of Surgery, Dallas.
Fry
R E
RE
Clagett
G P
GP
Fisher
D F
DF
Fry
W J
WJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000601:surgery; D006083:Graft Occlusion, Vascular; D006085:Graft Survival; D006801:Humans; D007511:Ischemia / Q000601:surgery; D015993:Life Tables; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D012501:Saphenous Vein / Q000637:transplantation*