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The Journal of Cardiovascular Surgery 2000 February;41(1):79-82

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Value of the profundapopliteal collateral index for selecting between an in-flow and sequential arterial reconstruction in patients with multisegment arterial occlusive disease

Mawatari K. *, Muto Y. *, Komori K. **, Kawasaki K. *, Okazaki J. **, Eguchi D. H. **, Kuma S. **, Ikeda T. *, Sugimachi K. **

From the *Department of Surgery, Fukuoka City Hospital *Second Department of Surgery, Faculty of Medicine, Kyusyu University, Fukuoka, Japan


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Back­ground. It ­remains dif­fi­cult for sur­geons to ­choose ­between an in-­flow and sequen­tial arte­rial recon­struc­tion in ­patients ­with mul­ti­seg­ment arte­rial occlu­sive dis­ease. In addi­tion, the ­exact cri­terion for the ­proper revas­cu­lar­iza­tion pro­ce­dures of ­these ­patients ­also ­remains ­obscure.
­Methods. The pro­fun­da­pop­li­teal col­lat­eral ­index (­PPCI) was deter­mined in all ­patients ­with occlu­sions of ­both the aor­toi­liac and super­fi­cial ­femoral ­arteries ­prior to under­going an arte­rial ­bypass. The ­PPCI in the ­inflow ­bypass (IB) was ­also com­pared ­with the sequen­tial ­bypass (SB).
­Results. The symp­toms of all ­patients under­going ­either IB or SB ­improved. Pre­op­er­a­tively, the ­average ­PPCI in IB ­patients was sig­nif­i­cantly ­lower ­than ­that in SB ­patients. In addi­tion, no sig­nif­i­cant dif­fer­ence was ­observed in the ­increased ­average ­rate of the ­ankle bra­chial ­index (ABI) ­between IB and SB.
Con­clu­sions. The ­PPCI is an accu­rate pre­dictor of the hemo­dy­namic poten­tial of the genic­u­late col­lat­erals. In ­cases ­with a low ­PPCI, espe­cially in ­patients ­with mul­ti­seg­ment arte­rial occlu­sive dis­ease, ­in-flow pro­ce­dures ­alone may ­often be suf­fi­cient for the suc­cessful treat­ment of ­such ­patients. The ­PPCI is ­thus con­sid­ered to be ­useful for ­selecting the ­optimal revas­cu­lar­iza­tion pro­ce­dures.

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