[Results of infrainguinal revascularization in patients with end-stage renal disease].
OBJECTIVE
The aim of this retrospective study was to evaluate the efficacy of bypass in patients with endstage renal disease (ESRD) and to determine predictive factors and precise bypass indications.


METHODS
Forty one patients with ESRD underwent 50 bypass, 6 limbs were stage II and 44 stage III or IV according to Leriche and Fontaine classification. Revascularisations procedures were 47 infrainguinal bypass and 3 miscellaneous. Median follow up was 17,0+/-15,7 months.


RESULTS
Perioperative mortality rate was 12% (n = 6). Morbidity was as follow : 1 perioperative major imputation and 8 secondary ones. There were 26 secondary death (12 from cardiac events), cumulative survival rate declined to 42,9+/-7,7% and limb salvage rate to 77,2+/-7,5% at 2 years. Primary and secondary potency rates were 53,5+/-10,4% and 70,6+/-10%. Quality of life was good in 28% of revascularised patients. Among risk factors, myocardial events showed a statistical significance in predicting survival, good runoff and bypass occlusion showed a statistical significance in predicting limb salvage.


CONCLUSIONS
Revascularisation can be performed in ESRD patients. However to improve the results full evaluation of myocardial risks, skin lesions and infection of the feet, available autologous vein and nutritional status may be needed in those patients.
Chambon
J P
JP
Service de chirurgie adultes Ouest A, CHU de Lille, hôpital Claude-Huriez, France. jp-chambon@chru-lille.fr <jp-chambon@chru-lille.fr>
Alarcon
B
B
N'Guyen
H D
HD
Gaillard
R
R
Pagniez
D
D
Dumont
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007264:Inguinal Canal / Q000098:blood supply / Q000601:surgery; D007668:Kidney / Q000098:blood supply; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures