Asian Cardiovasc Thorac Ann 2004;12:208-212
© 2004 Asia Publishing EXchange Ltd
Long Term Outcome of Femoropopliteal Bypass for Claudication and Critical Ischemia
Masayoshi Kobayashi, MD,
Kenji Hida, MD,
Hiroo Shikata, MD,
Shigeru Sakamoto, MD,
Junichi Matsubara, MD
Department of Thoracic and Cardiovascular Surgery, Kanazawa Medical University, Ishikawa, Japan
For reprint information contact: Masayoshi Kobayashi, MD Tel: 81 52 744 2224 Fax: 81 52 744 2226 Email: koba{at}med.nagoya-u.ac.jp Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku Nagoya 466–8550, Japan.
We performed 167 femoropopliteal bypass surgeries in 151 patients (95 patients underwent above-knee bypass and 56 below-knee bypass) from December 1985 to December 2000 with the use of prosthetic graft or autologous vein graft. We compared primary patency rates between age, sex, graft material, distal anastomotic site and severity of ischemia, considering their survival rates to elucidate the long-term outcome of above-knee and below-knee femoropopliteal bypass. The 10 year patency rate for above-knee bypass was 47.4%, compared to 36.9% for below-knee ( p < 0.01). Better results were found after bypass surgery for claudicants than for critical ischemia ( p < 0.05). With regard to graft material and age categories, there were unexpectedly no statistical differences in either above-knee or below-knee anastomosis. The survival rate at 10 years in claudicants was 51.2%, compared to 15.9% with critical ischemia ( p < 0.01). Mortality was much influenced by ischemic heart disease ( p < 0.002) and the age of patient ( p < 0.05). The results after above-knee bypass had comparable patency, whereas the results after below-knee bypass were disappointing. Below-knee arterial reconstruction for claudicants should be carefully considered and might be recommended only to patients with critical ischemia.
Copyright © 2004 by the Asia Publishing EXchange Ltd.
