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CURRENT ISSUEITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery

Official Journal of the Italian Society of Vascular and Endovascular Surgery
Indexed/Abstracted in: EMBASE, Scopus

Frequency: Quarterly

ISSN 1824-4777

Online ISSN 1827-1847

 

Giornale Italiano di Chirurgia Vascolare 2001 March;8(1):25-32

    ORIGINAL ARTICLES

Results of distal revascularisation. Follow-up of 50 cases

Tassinari L., Carmo M., Mingazzini P., De Angelis G. A. T., Settembrini P. G. *

From the Division of Vascular Surgery “S. Carlo Borromeo” Hospital, Milan
* 2nd Department of Vascular Surgery University of Milan

Background. The aim of ­this ­study was to eval­u­ate the ­results of dis­tal revas­cu­lar­isa­tion, and in par­tic­u­lar to ana­lyse the ­impact of var­i­ous ­risk fac­tors (dia­betes mel­lit­us, chron­ic ­renal insuf­fi­cien­cy, ­absence of ­vein ­graft, troph­ic ­lesions) on the out­come.
Methods. A ­total of 50 femor­o­dis­tal ­bypass oper­a­tions ­were per­formed ­between June 1994 and June 1999. The indi­ca­tion for sur­gery was ­limb-threat­en­ing ische­mia in 42 cas­es and ­severe claud­i­ca­tion in 8 cas­es. The ­great saph­e­nous ­vein was util­ised in 30 ­patients, com­pos­ite ­grafts in 14 and syn­thet­ic ­grafts ­alone in 6. The aver­age fol­low-up of ­these ­patients was 16 ­months (­range: 1-54). Bypass paten­cy was ­assessed ­using c.w. Doppler ­scan. In cas­es ­where the Dop­pler was not ­clear-cut, an angio­gra­phy was per­formed. Global pri­mary and sec­on­dary paten­cy ­rates ­were cal­cu­lat­ed. The ­authors com­pared the one-­year sec­on­dary paten­cy ­rates ­among the fol­low­ing ­risk class­es: 3rd vs 4th ­stage, dia­betes vs non-dia­bet­ics, dia­bet­ics with­out ­vein ­graft vs dia­bet­ics ­with ­vein ­graft, dia­bet­ics at 3rd ­stage vs dia­bet­ics at 4th ­stage, chron­ic ­renal insuf­fi­cien­cy vs non-chron­ic ­renal insuf­fi­cien­cy, dia­bet­ics at 4th ­stage with­out ­vein ­graft vs oth­er dia­bet­ics.
Results. Limb sal­vage was ­achieved in 35 cas­es (70%). The one-­month, one-­year and 3-­year pri­mary and sec­on­dary paten­cy ­rates ­were respec­tive­ly 74% and 82%, 59% and 72%, 54% and 72%. None of the com­par­i­sons ­between the ­risk class­es was sta­tis­ti­cal­ly sig­nif­i­cant. Diabetics at 4th ­stage with­out ­vein ­graft had the ­worst out­comes.
Conclusions. Primary ampu­ta­tion ­appears to be jus­ti­fied ­only in ­severe and ­well-select­ed cas­es.

language: English, Italian


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