Predictive factors for adverse outcome of pedal bypasses.
OBJECTIVE
to identify the risk factors affecting the outcome of bypass grafts to the foot arteries.


METHODS
longitudinal observational study from a single institution.


METHODS
one-hundred and sixty-five infrainguinal bypasses to the foot arteries were performed in 162 legs of 149 patients with critical leg ischaemia.


RESULTS
at 1-month, 1-year, 2-year and 3-year follow-up, the primary patency rates were 74%, 43%, 38% and 34%, the secondary patency rates were 82%, 50%, 47% and 41%, the leg salvage rates were 88%, 66%, 66% and 60%, survival rates were 95%, 76%, 69% and 55%, whereas 82%, 53%, 49% and 36% of patients were alive with salvaged leg, respectively. Low preoperative plasma concentrations of C-reactive protein (CRP) and short grafts with more distal arterial inflow had a better outcome. Better primary and secondary patency rates were also achieved by experienced surgeons and by the use of in situ saphenous vein grafts. Pedal run-off scoring did not have any impact on the outcome of pedal bypasses.


CONCLUSIONS
short pedal bypasses using in situ saphenous vein technique, done by an experienced surgeon, have the best outcome. Revascularisation to the foot arteries may carry a poor outcome in patients with elevated preoperative CRP concentration.
Biancari
F
F
Division of Vascular Surgery, Department of Surgery, Helsinki, Finland.
Albäck
A
A
Kantonen
I
I
Luther
M
M
Lepäntalo
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001807:Blood Vessel Prosthesis; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000601:surgery*; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome; D014654:Vascular Patency; D014680:Veins / Q000637:transplantation
D002097:C-Reactive Protein