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KMID : 0904020080240010025
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Journal of Korean Society for Vascular Surgery
2008 Volume.24 No. 1 p.25 ~ p.29
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The Relation between Distal Runoff and Clinical Outcome after Aorto-iliac Reconstruction Surgery
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Kim Hyang-Kyoung
Cho Yong-Pil
Moon Ki-Myung
Kwon Tae-Won
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Abstract
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Purpose: We sought to evaluate the relationship between distal runoff and long-term graft patency in aorto-iliac occlusive disease.
Method: A retrospective review was performed on 192 patients with aorto-iliac occlusive disease who underwent surgery between September 1995 and November 2005. Patients who underwent percutaneous angioplasty or stent placement were excluded. Preoperative angiograms were scored according to the SVS/ISVS Ad Hoc Committee guidelines.
Result: The mean duration of follow-up was 50 months. Procedure indications consisted of claudication in 68 patients and critical limb ischemia in 124 patients. Procedures included 176 bypasses (50 aorto-iliac/aorto-femoral, 32 ilio-femoral, 46 axillo-femoral, and 48 femoro-femoral) and 16 endarterectomies with patch angioplasty. Overall 5-year patency rate was 84.1%. Higher primary patency was observed when the occlusion score of the superficial femoral artery (SFA) or deep femoral artery (DFA) was lower than 2 (P＜0.05). Cox proportional hazard model showed run-off resistance values to be significant determinants of graft patency (p=0.000, Exp(B)=1.236). The group that underwent profundoplasty had significantly better long-term patency (P=0.009).
Conclusion: Poor distal runoff score was related to lower primary patency. In patients with aorto-iliac occlusive disease and poor distal outflow, profundoplasty can improve primary patency.
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KEYWORD
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Aorto-iliac occlusive disease, Runoff score, Graft patency
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