Evaluation of distal run-off before femorodistal bypass.
The quality of distal run-off is one of the most important factors in determining outcome of femorodistal bypass. Accurate evaluation is important. Preoperative intra-arterial digital subtraction angiography and Doppler evaluation with pulse-generated augmentation of 90 patients who underwent femorodistal reconstruction were compared with postoperative angiography. Underestimation of distal run-off of the calf vessels occurred in 33% of cases by preoperative intra-arterial digital subtraction angiography. A below-knee pulse-generated run-off score of 3 or less was associated with a 12-month cumulative patency of 73% compared with 85% with a below-knee pulse-generated run-off score of 4 or more (P=0.079, log rank test; P =0.060, Wilcoxon signed rank test). The 12-month cumulative patency for grafts with a complete, incomplete and occluded arch as defined by pulse-generated run-off was 78, 90 and 38% respectively (P<0.0001 log rank and Wilcoxon signed rank tests). Preoperative evaluation of distal run-off before femorodistal bypass should not be based exclusively on intra-arterial digital subtraction angiography.
Davies
A H
AH
Department of Vascular Studies, Bristol Royal Infirmary, Bristol, UK.
Magee
T R
TR
Parry
R
R
Horrocks
M
M
Baird
R N
RN
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011674:Pulse / Q000502:physiology; D018608:Ultrasonography, Doppler; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D014654:Vascular Patency