Management of combined segment disease.
Eighty-five of 148 inflow procedures were performed for combined segment disease. Our study shows that aortofemoral bypass is clinically and functionally superior to axillofemoral bypass in limbs with combined segment disease and hemodynamic criteria for limb salvage. The results of these two procedures are comparable for claudicant limbs. A derivative of segmental plethysmography, the predictive index, can select preoperatively those limbs that will fail to respond to aortofemoral bypass alone. Finally, either in limbs selected for aortofemoral bypass with both ischemic tissue lesions and a predictive index greater than 0.2 or in limbs selected for axillofemoral bypass with ischemic tissue lesions alone, a synchronous procedure can be performed with relatively low morbidity and excellent early functional results.
D000842:Ankle / Q000098:blood supply; D001012:Aorta, Abdominal / Q000601:surgery; D001132:Arm / Q000098:blood supply; D001366:Axillary Artery / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000379:methods*; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000601:surgery*; D007866:Leg / Q000098:blood supply; D010992:Plethysmography, Impedance; D011093:Polyethylene Terephthalates; D011150:Popliteal Artery / Q000601:surgery; D012039:Regional Blood Flow; D013997:Time Factors
D011093:Polyethylene Terephthalates