The Natural History of Bilateral Aortofemoral Bypass Grafts for Ischemia of the Lower Extremities

Malone, James M.; Moore, Wesley S.; Goldstone, Jerry

doi:10.1001/archsurg.1975.01360170040005

Cited by 165 publications

(21 citation statements)

References 26 publications

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“…Iliac lesions longer than 5 cm were not analyzed because there were only 12 and most of these could not be dilated. Nine lesions longer than 10 cm were encountered in the femoral artery.…”

Section: -mentioning

confidence: 99%

“…However, if one looks only at the 1-cm iliac stenotic lesions treated by PTA, the patency rate of 85.8% after three years is comparable with that achieved by Malone et al with surgery. 12 We have two published series of operations from this institution of patients who underwent femoropopliteal bypass surgery for treatment of claudication15 and limb salvage.16 These earlier patients came from the same population as those who underwent PTA. A comparison of results at one, two, and three years, broken down by claudication and salvage, is given in Table 4.…”

Section: Does Patient's Associated Disease State Influencementioning

confidence: 99%

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Long-term Results of Transluminal Angioplasty of the Iliac and Femoral Arteries

Spence¹,

Freiman²,

Gatenby³

et al. 1981

Arch Surg

191

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“…Iliac lesions longer than 5 cm were not analyzed because there were only 12 and most of these could not be dilated. Nine lesions longer than 10 cm were encountered in the femoral artery.…”

Section: -mentioning

confidence: 99%

Section: Does Patient's Associated Disease State Influencementioning

confidence: 99%

Long-term Results of Transluminal Angioplasty of the Iliac and Femoral Arteries

Spence¹,

Freiman²,

Gatenby³

et al. 1981

Arch Surg

191

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“…It is very important to emphasize that this statistic is related only to ring-stripper endarterectomy, since the usual technique employed to treat aortoiliac-femoral occlusions is synthetic bypass. The reported mortality rate following aortobifemoral bypass surgery ranges from 2% to 5% 28,33,37,[41][42][43] . Initially, there were technical difficulties that included determination of the ideal surgical access and endarterectomy extension.…”

Section: Discussionmentioning

confidence: 99%

Aortofemoral thromboendarterectomy

et al. 2002

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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.

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“…Fifty-seven diabetics and 43 nondiabetics constituted the study group. There were 40 insulindependent diabetics (including five with juvenile-onset diabetes), 13 receiving oral agents, and four with diet-controlled diabetes. The patient profile is presented in Table 1.…”

Section: Methodsmentioning

confidence: 99%

“…Previous reports have noted poor graft patency, limb salvage, and patient survival in diabetics undergoing aortic reconstruction for occlusive disease. 13 The relatively low number of diabetics in each series led us to review our experience with a largely diabetic population.…”

mentioning

confidence: 99%