Arteriosclerosis in popliteal artery trifurcation as a predictor for myocardial infarction after arterial reconstructive operation.
The frequency of myocardial infarction and mortality within 30 days after lower limb vascular reconstruction, in relation to the extent of atherosclerotic lesions in the trifurcation of the popliteal artery, have been retrospectively analyzed in 158 consecutive patients reconstructed in the aortoiliac region and 239 consecutive patients undergoing femorodistal bypass. Among the patients without trifurcational disease (TFD) none had myocardial infarction develop postoperatively, as compared with four of the 50 patients with TFD in the aortoiliac series (p less than 0.05) and 18 of the 174 patients with TFD in the femorodistal series (p less than 0.05). In nine instances, the cause of death was myocardial infarction. The strong correlation between postoperative myocardial infarction and the presence of TFD, may be due to a direct correlation between coronary artery disease and TFD. The finding is of practical importance in the selection of treatment for patients with circulatory disorders of the lower limbs. The finding facilitates the preoperative identification of patients liable to have myocardial infarction develop. Indications for operation can be made more stringent and optimal intraoperative and postoperative monitoring can be instituted.
D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000368:Aged; D000375:Aging; D000671:Amputation, Surgical; D001161:Arteriosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001344:Autopsy; D003327:Coronary Disease / Q000175:diagnosis; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007083:Iliac Artery / Q000601:surgery; D007432:Intraoperative Period; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D012306:Risk