[The treatment of failed low limb prosthetic graft bypass for the chronic low limb ischemia: a report of 19 cases].
OBJECTIVE
To determine the optimal strategies of occluded prosthetic bypass and to assess the risk factors which influence the outcome.


METHODS
From September 2003 to December 2004, 19 cases of failed low limb prosthetic graft were treated in the Peking Union Medical College hospital. All of them underwent operation, and the strategies of operation were determined by the cause assessed pre-procedure. Four cases underwent thrombectomy only, 5 cases underwent thrombectomy combined with the distal anastomosed-plasty, 3 cases underwent thrombectomy combined with profundaplasty, 2 cases underwent vascular re-construction with new prosthetic graft, 1 case underwent external iliac artery endarterectomy, 2 cases underwent stent cell transplantation, and the last 2 cases underwent amputated since the limbs showed un-salvageable. All the cases got at least 1 year following-up.


RESULTS
In the 17 vascular reconstruction cases except the 2 cases who underwent amputated, 14 cases (82.4%) got firstly successes, according to their limb ischemia symptom got well, but the rest 3 cases (17.6%) failed. And the mortality is 10.5% (2 cases). In the 1 year following-up, the prosthetic graft patency was 35.3% (6 cases), and the limb salvage was 76.4% (13 cases).


CONCLUSIONS
Optimal resolution for prosthetic graft re-occlusion should be based on good judgment of the occlusion cause. Then proper correcting the cause plus right following-up program could be the risk factors of prognosis.
Ye
Wei
W
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Liu
Chang-wei
CW
Guan
Heng
H
Liu
Bao
B
Li
Yong-jun
YJ
Zheng
Yue-hong
YH
Wang
Sheng
S
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D017131:Thrombectomy