[Chronic critical leg ischemia: revascularization of the isolated popliteal segment in comparison with femoro-distal bypass].
Several patients with chronic critical limb ischemia show angiographically an isolated popliteal segment (IPS) and a single calf vessel (SCV) with no direct communication to the former. In this situation a bypass can be inserted from the common femoral artery to the IPS or to the SCV. The results of 73 bypass procedures--40 to an isolated popliteal segment and 33 to a single calf vessel for limb salvage--were prospectively evaluated. Eighty percent of the grafts were performed with an autogenous saphenous vein (ASV), the rest with a thin wall polytetrafluoroethylene (PTFE) prosthesis. The mean age of our patients was 75 years and many suffered from cardiovascular disease. The operative mortality rate was 3% and the mean postoperative survival 32 months. Three year patency and limb salvage rates for ASV grafts was 83% and 87% (IPS) respectively 77% and 76% (MCV); for PTFE grafts 58% and 88% (IPS) respectively 17% and 50% (MCV). There was no significant difference found in patency and limb salvage rates of the two procedures if the graft was an autogenous saphenous vein (p > 0.05). The PTFE prosthesis was only suitable for grafts inserted to the isolated popliteal segment.
Mosimann
U P
UP
Universitätsklinik für Thorax-, Herz- und Gefässchirurgie, Inselspital Bern.
Stirnemann
P
P
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001807:Blood Vessel Prosthesis; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000401:mortality; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D015996:Survival Rate; D014680:Veins / Q000637:transplantation*
D011138:Polytetrafluoroethylene
Chronisch kritische Beinischämie: Die Revaskularisation des isolierten Poplitealsegmentes im Vergleich zum femoro-distalen Bypass.