Aggressive revascularization of the ischemic lower extremities in atherosclerotic occlusive diseases or acute embolic arterial occusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by
some
authors. To evaluate clinical pattern and operative outcome of the ischemic lower extremity, surgical experience in 101 patients who were admitted to Dong-A University Hospital between March 1990 and August 1995 was analyzed.
The patients were 92 males and 9 females ranging from 25 to 87 years of age. The underlying causes of arterial occlusive disease were atherosclerotic obliterances in 54 case, Buerger's disease in 20 cases, thromboembolism in 24 cases, vascular
trauma in
3 cases and pseudoaneurysm in 3 cases.
The major arterial occlusive sites of atherosclerotic obliterance were femoral artery in 30 cases, iliac artery in 23 cases, popliteal artery in 10 cases, distal aorta in 6 cases and the major arterial occlusive sites of Buerger's disease were
posterior
tibial artery in 14 cases, anterior tibial artery in 8 cases, popliteal artery in 5 cases.
The operative procedures of arterial occlusive disease were bypass graft operation in 61 cases, thromboembolectomy in 21 cases, sympathectomy in 20 cases.
Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 61 cases which included femoro-popliteal bypass in 21 cases, femoro-femoral bypass in 15 cases, axillo-bifemoral bypass in 7 cases, aorto-bifemoral with
inverted
Y-graft in 3 cases. femoro-profundafemoral bypass in 3 cases, popliteo-tibial bypass in 2 cases, aorto-iliac bypass in case.
Over all postoperative patency rates were 83.6% at l year. 75.5% at 3 years and limb salvage rate was 86.8%.
Six patients died in the hospital following vascular surgery for ischemic lower extremities, although the causes of death were not directly related to the vascular reconstructive operative proccedures. The leading causes of death were in the
order
of
multiple organ failure, acute renal failure, and sepsis.
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