[Clinical effects of revascularization in lower limb ischemia].
OBJECTIVE
To investigate the clinical effects of revascularization in lower extremity for severe ischemia.


METHODS
Fifty-six lower limbs with severe ischemia in 49 patients were evaluated retrospectively, who underwent surgical intervention from January of 1995 to December of 2000. By arteriography, the actual anatomic distributions of occlusive disease included infrarenal aorta-bicommon iliac arteries, abdominal aorta-bicommon iliac arteries, iliac artery, and femoral artery or femoropopliteal artery. The indication for surgery was disabling claudication, rest pain and gangrene. Fourteen limbs in 12 cases received arterialization of femoral venous system by artificial venous-arterial fistula. Artificial vascular grafts were implanted in 33 limbs of 28 cases, endarterectomy and patch profundaplasty were performed in 5 limbs of 5 cases, and primary amputation was carried out in 4 cases.


RESULTS
During 38 months follow-up in average, 4 limbs were amputated within 52 revascularizated limbs, and accumulated amputation rate was 14.3%. Patency rate was 68.4% in arterial revascularization limbs (26/38 limbs), and limb survival rate was 94.7%(36/38 limbs) by procedure of artificial vascular grafts, endarterectomy and patch profundaplasty. Limb survival rate in procedure of artificial venous-arterial fistula was 85.7%(12/14 limbs).


CONCLUSIONS
In treatment of severe lower extremity ischemia, the effective revascularization can be achieved by artificial vascular bypass, endarterectomy and patch profundaplasty, or arterialization of femoral venous system. Options in the surgical management should depend on individual. Arteriography is essential for revascularization and properly planning a practicable surgical approach.
Li
X X
XX
Department of Vascular Surgery, First Affiliated Hospital, Sun Yat-sen University Medical Sciences, Guangzhou Guangdong, P.R. China 510080. lix2@21cn.com
Lu
W M
WM
Chang
G Q
GQ
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001158:Arteries / Q000601:surgery; D001161:Arteriosclerosis / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures