Crural artery bypass with the autogenous greater saphenous vein.
OBJECTIVE
To evaluate the long-term outcome of greater saphenous vein (GSV) infrapopliteal revascularisation in a single centre over a 10 year period.


METHODS
Fourty-one variables relating to a consecutive series of 90 crural artery GSV(76% in situ) bypasses in 81 patients (1990-2000) were analysed. The mean age of the 47 men and 34 women was 70 years. Limb-threatening ischaemia was present in 96% of cases, claudication in four patients. In 18 patients, surgery was 'redo'.


RESULTS
The perioperative mortality was 3% (n=3). Patient survival was 54% at 4 years. Independent risk factors affecting survival were chronic renal insufficiency (p=0.04), hypertension (p=0.02), and ischaemic heart disease (p=0.01). Four bypasses thrombosed within 30 days. Three of them could be successfully reopened. Mean follow-up was 39 months. The primary patency rate at 4 years was 80%. Chronic renal insufficiency revealed to be the single independent risk factor for graft thrombosis (p=0.03, RR=12.4). The 4-year limb salvage rate was 88%. No independent risk factor affecting the limb salvage could be identified.


CONCLUSIONS
Crural artery revascularisation is a valuable option for the management of limb threatening infrapopliteal arterial occlusive disease.
Van Damme
H
H
Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, CHU du Sart-Tilman, Belgium.
Zhang
L
L
Baguet
E
E
Creemers
E
E
Albert
A
A
Limet
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome