title: Bypass versus primary major amputation in patients with femoropopliteal distal disease and a threatened limb.
abstract: Over a 36-month period 201 patients came to the Vascular Service, King Edward VIII Hospital, with atherosclerotic occlusive disease involving the femoropopliteal or femoro-infrapopliteal segments. On the basis of angiographic and clinical assessment 113 patients underwent bypass procedures and in 88 amputation was performed. The two groups were well matched as regards age and clinical condition. In-hospital mortality was 3,5% and 2,3% in the bypass and amputation groups respectively and the time spent in hospital was 5-6 weeks. In the longer term the desired achievement was limb salvage or ambulation on a prosthesis. Cumulative life-table analysis showed that more patients in the limb-salvage group than amputees were ambulant over any given time interval, although at 36 months after operation there was only an 8-10% difference. The results suggest that it is worth while attempting limb salvage in these cases, certainly as far as the first 3 years after operation are concerned.
mesh_terms: D000671:Amputation, Surgical / Q000534:rehabilitation; D001161:Arteriosclerosis / Q000534:rehabilitation / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D011183:Postoperative Complications; D012306:Risk
chemical_list: D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene