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The Journal of Cardiovascular Surgery 2000 October;41(5):753-8

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Is semi-closed endarterectomy of the superficial femoral artery combined with a short venous bypass in case of insufficient venous material an acceptable alternative for limb-threatening ischemia?

Rijbroek A., Vermeulen E. G. J., Wisselink W., Rauwerda J. A.

From the Department of General Surgery Vascular Surgical Unit University Hospital “Vrije Universiteit” Amsterdam, The Netherlands


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Background. The aim of ­this ­study was to ana­lyse the ­results of infra­gen­u­al arte­ri­al revas­cu­lar­isa­tion ­using sem­i­closed endar­te­rec­to­my of the super­fi­cial femo­ral ­artery com­bined ­with a ­short ­venous ­bypass in ­patients ­with crit­i­cal leg ische­mia and insuf­fi­cient ­venous mate­ri­al for a straight­for­ward fem­o­roc­ru­ral recon­struc­tion.
Methods. From December 1990 ­through December 1998 thir­ty ­patients ­were stud­ied (22 ­males and 8 ­females; ­mean age 65 ­years, ­range 31-92 ­years). The ­mean fol­low-up was 26 ­months (­range 1-96 ­months). Cumulative pri­mary paten­cy and ­limb sal­vage ­rates ­were cal­cu­lat­ed accord­ing to ­life-­table anal­y­sis.
Results. The cumu­la­tive pri­mary paten­cy was 60.3% at 1 ­year and 48.4% at 3 ­years. The ­limb sal­vage ­rate was 68.6% at 1 and at 3 ­years.
Conclusions. In ­patients ­with ­limb-threat­en­ing ische­mia and ­lack of ­venous mate­ri­al for a straight­for­ward ­venous fem­o­roc­ru­ral ­bypass, ­semi-­closed endar­te­rec­to­my of the super­fi­cial femo­ral ­artery com­bined ­with a ­short pop­li­teo-cru­ral ­bypass pro­vides a ­good alter­na­tive.

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