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Prognostic indicators in femoropopliteal reconstructions
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1975
Summary
Predicting femoropopliteal graft failure is crucial. A low ankle pressure index (<0.20) and intraoperative graft flow (<70 ml/min) strongly indicate early thrombosis, suggesting futility in these cases.
Area of Science:
- Vascular Surgery
- Medical Engineering
Background:
- Early failure of femoropopliteal grafts impacts patient outcomes.
- Identifying reliable prognostic indicators is essential for patient selection.
Purpose of the Study:
- To analyze prognostic indicators for early failure in vein femoropopliteal grafts.
- To determine the value of preoperative and intraoperative assessments in predicting graft success.
Main Methods:
- Analysis of 115 vein femoropopliteal grafts.
- Preoperative Doppler ultrasound assessment in 112 patients.
- Intraoperative graft flow measurement in 98 patients.
- Evaluation of ankle pressure index (API).
Main Results:
- Early graft failure was linked to rest pain, gangrene, and poor runoff, but these lacked predictive value.
- 91% of patients with an ankle pressure index <0.20 experienced early graft thrombosis.
- Grafts with intraoperative flow <70 ml/min uniformly thrombosed.
- Significant correlation (r=.52) found between API and intraoperative flow.
Conclusions:
- Ankle pressure index and intraoperative graft flow are valuable prognostic indicators for femoropopliteal graft failure.
- Arterial reconstruction may be futile in patients with API <0.20.
- These parameters aid in selecting appropriate candidates for femoropopliteal reconstructions.