Sequential grafts for limb salvage in the presence of widespread occlusive vascular disease. A review of twenty patients.
Twenty patients with widespread occlusive vascular disease received sequential bypass grafts for lower-limb salvage. In 16 patients an isolated common femoral or profunda segment was perfused by a proximal graft and run-off was augmented by femoropopliteal bypass. In 4 a femoropopliteal bypass constituted the proximal component perfusing an isolated popliteal segment, run-off being increased by a popliteal-to-tibial graft. Dacron, expanded polytetrafluoroethylene (PTFE) (Gore-Tex), and autogenous vein grafts were used. The mean period of follow-up was 10.6 +/- 7 months and 70% of the limbs were salvaged. Thirteen graft systems remain currently patent, 4 have thrombosed, 2 patients died with patent grafts, and 1 required amputation despite graft patency.
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008722:Methods; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D014680:Veins / Q000637:transplantation*