Late Results of Autogenous Vein Bypass Grafts in Femoropopliteal Arterial Occlusion

Baddeley, R. M.; Ashton, F.; Slaney, G; Barnes, A. D.

doi:10.1136/bmj.1.5697.653

Cited by 42 publications

(12 citation statements)

References 8 publications

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“…This can also explain the lower flow rates found in this patient group. The present results do not tend to support the statement of Baddeley et al (8) that there is a significant risk of kinking of the graft during movement of the knee joint leading to an increased risk of graft failure. On the other hand, the present data do not support the advocates of routine distal arterial anastomosis either (22, 23).…”

Section: Discussioncontrasting

confidence: 99%

“…We suggest that this vein can be utilized more often as a femoropopliteal graft than is the case in many vascular clinics where saphenous veins with a smallest diameter of less than 5 mm are rejected (8,20,21). The significantly lower flow rates in small grafts which were found in the present study may partly be explained by the percentage of reconstructions performed in limbs with a poor run-off, which was considerably higher than in the group with large grafts.…”

Section: Discussionmentioning

confidence: 44%

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Factors determining outcome of reversed saphenous vein femoropopliteal bypass grafts

Sonnenfeld

Cronestrand

1980

Journal of British Surgery

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The investigation was designed to study factors that might be of predictive value in femoropopliteal vein bypass grafting. A series of 146 grafts had a cumulative 5-year graft patency of 82.5 per cent. Five-year limb survival rate in salvage cases was 77.9 per cent. These results are encouraging. However, taking certain factors into account, the patency rates varied. In limbs with claudication, the 5-year graft patency rate was significantly higher than in salvage procedures (P < 0.05). Basal and maximal (during pharmacological vasodilatation) intraoperative graft flow rates were also significantly higher in claudicating limbs (P < 0.01). Reconstructions in limbs with a good run-off had better patency and flow rates than in limbs with a poor run-off (P < 0.001). This suggests that progression of distal atherosclerosis is a major factor for late graft thrombosis. The incidence of graft thrombosis was correlated with the flow rates (P < 0.01). Age, the presence of diabetes, graft diameter and the site of the distal anastomosis did not affect patency.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 44%

Factors determining outcome of reversed saphenous vein femoropopliteal bypass grafts

Sonnenfeld

Cronestrand

1980

Journal of British Surgery

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“…Very good late results, in terms of claudication relief, have been quoted after femoropopliteal bypass by several authors (Linton and Darling, 1962;Baddeley et al, 1970;Cutler et al, 1976). These reports are particularly significant since it seems likely that a bypass graft could have been inserted in well over half of the claudicants in the present series.…”

Section: Discussionmentioning

confidence: 84%

The long term results of profundaplasty in femoropopliteal arterial occlusion

Ward¹,

Morris-Jones²

1977

Journal of British Surgery

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The long term results of profundaplasty in the treatment of femoropopliteal arterial occlusion have been reviewed. Fifty patients have been studied with a mean follow-up period of 4 years (range 6 months to 8 years). Intermittent claudication was abolished or substantially improved in 5 of the 25 cases (20 percent); rest pain was relieved in 10 of the 25 cases (40 per cent), the remainder requiring a major amputation. Lumbar sympathectomy produced little additional benefit in either group. The mortality rate in the rest pain group was high and only 5 patients survived for more than 3 years with both legs intact. The state of the distal 'run-off' and the degree of preoperative profunda stenosis appeared to have little influence on the clinical outcome. After operation pedal pulses were restored in 16 per cent of those presenting with claudication. Profundaplasty was without significant effect on the ankle systolic pressure index both in patients with claudication and those with rest pain.

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“…Thereafter, venous grafts fail with exponential frequency and display an increase in thickness of fibrous tissue without atherosclerotic plaques. The late success rate (3-5 years) is in the order of 50% [57][58], With poor distal run-off, the patency rate is even lower [58]. Although the severity of obstructive disease in the distal arterial bed and the caliber of the recipient vessel are the most important determinants of graft patency, other factors may play a role.…”

Section: Graft Patency Ratementioning

confidence: 99%

“…Experience with saphenous vein femoro-popliteal bypass grafts may shed some light on the long-term prognosis [57][58][59]. The late results of this operation are less encouraging than the early ones.…”

Section: Graft Patency Ratementioning

confidence: 99%

Current Status of Aorto-Coronary Bypass Graft Surgery

Segal¹,

Kotler²,

Likoff³

et al. 1974

Cardiology

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The value of saphenous vein bypass surgery in the treatment of coronary artery disease will eventually be assessed through prospective randomized studies of homogeneous groups of patients undergoing either medical or surgical treatment. At present, there is insufficient evidence to demonstrate the beneficial effects of coronary bypass operations on prevention of myocardial infarction and prolongation of life. The improvement in the quality of life may be rewarding in patients with crippling angina pectoris in whom there is a major obstruction of the proximal coronary artery with good distal runoff and adequate ventricular function. This review summarizes our knowledge of the natural history of angina pectoris and examines the indications for a surgical approach in chronic, stable angina pectoris, in unstable angina, variant angina, main left coronary artery disease and acute myocardial infarction. Criteria for patient selection are tentatively defined.

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Late Results of Autogenous Vein Bypass Grafts in Femoropopliteal Arterial Occlusion

Cited by 42 publications

References 8 publications

Factors determining outcome of reversed saphenous vein femoropopliteal bypass grafts

Factors determining outcome of reversed saphenous vein femoropopliteal bypass grafts

The long term results of profundaplasty in femoropopliteal arterial occlusion

Current Status of Aorto-Coronary Bypass Graft Surgery

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