Cumulative patency and actual palliation in patients with claudication after aortofemoral bypass

Sladen, Joseph G.; Gllmour, Joseph L.; Wong, Roman W.

doi:10.1016/0002-9610(86)90240-0

Cited by 54 publications

(15 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This was originally termed "cumulative palliation" and is a benchmark for clinical decisions about which patients will benefit most from LE bypass surgery. 6 Because amputation and death are both considered failure end points, amputation-free survival rates will be significantly lower than crude limb salvage rates computed when deaths are right censored.…”

mentioning

confidence: 99%

Perioperative outcomes and amputation-free survival after lower extremity bypass surgery in California hospitals, 1996-1999, with follow-up through 2004

Feinglass

Sohn

Rodríguez

et al. 2009

Journal of Vascular Surgery

View full text Add to dashboard Cite

Long-term outcomes of LE bypass surgery were superior for high-volume hospital patients. Graft surveillance and risk factor follow-up care provide a major opportunity for quality improvement efforts. The contrast between traditional limb salvage and amputation-free survival outcomes raises questions about the value of surgical treatment, particularly for patients with limited life expectancy and without coding of tissue loss or critical limb ischemia.

show abstract

mentioning

confidence: 99%

Perioperative outcomes and amputation-free survival after lower extremity bypass surgery in California hospitals, 1996-1999, with follow-up through 2004

Feinglass

Sohn

Rodríguez

et al. 2009

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…1 Surgery, either with bypass graft or aortic endarterectomy, has been the traditional standard of care for infrarenal aortic occlusive disease, with good long-term patency rates of 70% to 75% at 10 years but a 5% to 10% early complication rate. [2][3][4] Percutaneous transluminal angioplasty (PTA) has been proposed as an alternative to surgery, and several series have demonstrated its safety and efficacy in localized stenoses of the distal infrarenal aorta [5][6][7][8][9][10][11] as well as in lesions involving the aortic bifurcation. [5][6][7]10 Stenting offers theoretic advantages over PTA, and its use has been established in several vascular beds, with excellent patency rates.…”

mentioning

confidence: 99%

Primary stenting for aortic lesions: From single stenoses to total aortoiliac occlusions

Klonaris¹,

Katsargyris²,

Tsekouras³

et al. 2008

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…These results were statistically significant and agree with those of other reported studies 14,27,28,43 . These excellent results support the use of surgical intervention in patients with intermittent claudication and good clinical status on preoperative evaluations 35,52,53 . Another important result is that longer thromboendarterectomies have longer patency times than shorter ones do.…”

Section: Discussionmentioning

confidence: 52%

“…Causes of occlusion were intimal hyperplasia and progression of atherosclerotic disease distal to prior thromboendarterectomy. Intimal hyperplasia is a very important issue still under study, especially in angioplasties, and cannot be avoided [46][47][48][49][50] Published data shows a 5-year patency rate of 64.9% to 91% for aortofemoral repair 9,24,28,33,37,38,51,52 . Factors such as age, gender, diabetes, type of repair (thromboendarterectomy or bypass) did not influence these results, but patient complaint was very important.…”

Section: Discussionmentioning

confidence: 99%

Aortofemoral thromboendarterectomy

et al. 2002

View full text Add to dashboard Cite

PURPOSE:To study whether endarterectomy is feasible in all patients with aortofemoral atherosclerotic obstruction, considering early and late results.METHODS: A clinical, prospective, and descriptive study carried out in a university hospital. Inclusion criteria were atherosclerotic aortofemoral obstructive disease, clinical status compatible with major surgery, and absence of prior restorative procedure. Exclusion criteria were aneurysm, inflammatory arterial disease, and prior restorative procedure found during surgery. Eighty patients entered the protocol, but 9 were excluded (11.2%). Seventy-one patients, mean age of 57.3 years, underwent endarterectomy. Operative indications were intermittent claudication and critical ischemia. A ring-stripper endarterectomy technique was employed in all patients. Results were related to age, gender, symptoms, presence of diabetes mellitus, extension of endarterectomy, and extent of obstructive disease. Chi square or Fisher exact tests were used when appropriate, and the Wilkoxon (Gehan) test was used to compare survival curves.RESULTS: Sixty-eight (100%) endarterectomies were patent at discharge. The mortality rate was 4.2%. The amputation rate (4.3%) was higher in diabetic patients and when there was associated femoropopliteal obstruction. The 5-year survival rate was 83.3%, and late deaths were mostly cardiovascular. Diabetes mellitus, age above 65 years, and associated femoropopliteal obstruction lowered the survival rate. The 5-year patency rate was 87.0%. Critical ischemia and less extensive endarterectomies were associated with a lower patency rate. There were no anastomotic aneurysms or deep infections.CONCLUSIONS: Aortofemoral thromboendarterectomy is feasible in 90% of patients, early mortality rate is low, diabetic patients and those with associated femoropopliteal obstructive disease have a higher mortality rate, amputation rate is low, late deaths are mostly cardiovascular, and late patency rate is high, and even higher in the intermittent claudication group.

show abstract

Cumulative patency and actual palliation in patients with claudication after aortofemoral bypass

Cited by 54 publications

References 6 publications

Perioperative outcomes and amputation-free survival after lower extremity bypass surgery in California hospitals, 1996-1999, with follow-up through 2004

Perioperative outcomes and amputation-free survival after lower extremity bypass surgery in California hospitals, 1996-1999, with follow-up through 2004

Primary stenting for aortic lesions: From single stenoses to total aortoiliac occlusions

Aortofemoral thromboendarterectomy

Contact Info

Product

Resources

About