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Long-term results of distal-origin bypass after prior femoro-popliteal angioplasty

BACKGROUND: To investigate whether prior staged percutaneous transluminal angioplasty of the femoro-popliteal segment influences long-term results of distal bypass grafts. - METHODS: Between October 1987 and January 2009, 261 distal origin grafts for critical limb ischemia were performed at a single...

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Main Authors: Demirel, Serdar (Author) , Winter, Christof (Author) , Bruijnen, Hans (Author) , Böckler, Dittmar (Author) , Attigah, Nicolas (Author) , Gamstätter, Gerhard (Author)
Format: Article (Journal)
Language:English
Published: 28 October 2010
In: Annals of vascular surgery
Year: 2010, Volume: 24, Issue: 8, Pages: 1024-1033
ISSN:1615-5947
DOI:10.1016/j.avsg.2010.06.002
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.avsg.2010.06.002
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Author Notes:Serdar Demirel, Christof Winter, Hans Bruijnen, Dittmar Böckler, Nicolas Attigah, Gerhard Gamstätter

MARC

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245 1 0 |a Long-term results of distal-origin bypass after prior femoro-popliteal angioplasty  |c Serdar Demirel, Christof Winter, Hans Bruijnen, Dittmar Böckler, Nicolas Attigah, Gerhard Gamstätter 
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520 |a BACKGROUND: To investigate whether prior staged percutaneous transluminal angioplasty of the femoro-popliteal segment influences long-term results of distal bypass grafts. - METHODS: Between October 1987 and January 2009, 261 distal origin grafts for critical limb ischemia were performed at a single institution. A total of 223 grafts had angiographic no inflow lesions (-PA-group). Additionally, 38 grafts were performed staged within 30 days after percutaneous femoro-popliteal angioplasty (+PA-group) because of 28 TASC A (73%) and 10 TASC B (27%) lesions. Postoperative graft surveillance was performed at 3, 6, 12, and 18 months, then annually thereafter. Treatment groups were compared with Kaplan-Meier analysis. - RESULTS: Follow-up ranged from 1 to 198 months (median, 34 months). The 5-year primary patency was 73% for the +PA-group and 62% for the -PA-group (p = 0.20). Assisted primary patency for the +PA-group at 5 years was 80% and for the -PA-group was 70% (p = 0.17). The corresponding secondary patency at 5 years was 84% for the +PA-group and 71% for the -PA-group (p = 0.12), respectively. Limb salvage and amputation free survival at 5 years were 84% and 46% for the +PA-group, and 81% and 37% for the -PA-group, respectively (p = 0.57, 0.92). Bypass-threatening stenosis of the inflow-vessel was detected for four (10.5%) cases in the +PA-group and for 21 (8%) in the -PA-group. - CONCLUSION: Long-term results of distal origin grafts performed after femoro-popliteal angioplasty because of TASC A and B lesions are comparable with those observed in distal origin grafts without proximal stenosis. Distal origin bypass grafting is not compromised by prior endovascular treatment of the inflow-vessel. 
650 4 |a Aged 
650 4 |a Aged, 80 and over 
650 4 |a Amputation, Surgical 
650 4 |a Angioplasty, Balloon 
650 4 |a Arterial Occlusive Diseases 
650 4 |a Blood Vessel Prosthesis Implantation 
650 4 |a Constriction, Pathologic 
650 4 |a Female 
650 4 |a Femoral Artery 
650 4 |a Germany 
650 4 |a Graft Occlusion, Vascular 
650 4 |a Humans 
650 4 |a Ischemia 
650 4 |a Kaplan-Meier Estimate 
650 4 |a Limb Salvage 
650 4 |a Male 
650 4 |a Middle Aged 
650 4 |a Popliteal Artery 
650 4 |a Registries 
650 4 |a Reoperation 
650 4 |a Retrospective Studies 
650 4 |a Risk Assessment 
650 4 |a Risk Factors 
650 4 |a Saphenous Vein 
650 4 |a Time Factors 
650 4 |a Treatment Outcome 
650 4 |a Vascular Grafting 
650 4 |a Vascular Patency 
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