Autogenous venous bypass grafts and limb salvage: 5-year results in 1971 and 1991 |
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| Affiliation: | 1. Departments of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA;2. Harris County Institute of Forensic Sciences, Houston, Texas, USA;3. Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA;4. Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA;5. Lyndon B. Johnson General Hospital, Harris Health, Houston, Texas, USA;6. Center for Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School and Memorial Hermann Hospital-Texas Medical Center, Houston, Texas, USA;7. “Lino Rossi” Research Center for the Study and Prevention of Unexpected Perinatal Death and Sudden Infant Death Syndrome, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy;8. Department of Pathology, Baylor College of Medicine and Texas Childrens Hospital, Houston, Texas, USA |
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| Abstract: | Claims have been made that the increased utilization of arterial reconstruction has not resulted in improved limb salvage. This report compares the resultsss of two series of patients with autogenous venous bypass grafts and examines the institutional trends at a major regional vascular center with these procedures. The two groups of patients underwent operation between 1957 and 1964 (group I) and 1982 and 1985 (group II) respectively. Each patient was followed for a minimum of 5 years or until death. This review showed that the demographics of the population and the nature of the operation changed dramatically over the 20-year period. Patients were older, had more medical co-morbid conditions, more operations were performed for salvage and more to vessels below the knee joint in the latter series. Despite these adverse factors, the 30-day patency rates were significantly better in the later group, 93% versus 76%. Likewise, limb salvage rates were improved both initially and after the 5-year period of observation. The 5-year primary patency, however, was no different between groups I and II, 60% versus 56%. Since both series preceded the use of duplex scanning for graft surveillance, even further improvements in both graft patency and limb salvage rates would be expected in patients currently treated. |
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