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KMID : 0904020010170010040
Journal of Korean Society for Vascular Surgery
2001 Volume.17 No. 1 p.40 ~ p.46
Clinical Analysis of Above-Knee Femoropopliteal Bypass on Chronic Lower Limb Ischemia




Abstract
Purpose: To elucidate overall aspects of femoropopliteal bypass including patency rate, risk factors for patency and complications. Method: We analyzed 61 limbs with atherosclerosis in 57 patients underwent above-knee femoropopliteal bypass surgery from September 1994 to April 2000 retrospectively. The mean age of the patients was 65.3 years (31~80 yr.) Operative indications included disabling claudication (54%), resting pain (11.5%), ischemic gangrene (or ulceration) (34.4%). Associated risk factors were cerebrovascular accident (51%), diabetes mellitus (39%), coronary artery disease (32%), hypertension (30%), hyperlipidemia (16%). We used PTFE (polytetrafluoroethylene) synthetic graft in all cases. Adjunctive procedures were performed in 13 cases, which were iliac artery stent insertion in 7 cases, balloon dilatation in 4 cases, neurolysis in 1 case, profundaplasty in 1 case. Result: Overall 1, 3, 5-year primary and secondary graft patency rates were 83.8%, 73.0%, 71.3% and 98.0%, 85.0%, 75.0%. 17 postoperative complications occured including 10 cases of leg edema, 3 cases of myocardiac infarction, 3 cases of cerebral infarction, 1 case of pneumonia. In uni- and multivariate analysis, run off score was the only significant factor influencing primary graft patency rate (p=0.013), but risk factors such as DM, smoking, hyperlipidemia had no statistical significancy on the primary and the secondary graft patency rates. Conclusion: We consider that run off score is the most important factor for predicting the graft patency as othet studies verified.
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