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Long-term prognosis for reconstruction of arterial lesions due to arteriosclerosis
Insights
Arteriosclerosis reconstructive surgery showed a 59% patency rate over 3-8 years. Poor survival rates were linked to hypertension, with aggressive reconstruction potentially beneficial for early-stage hypertension but requiring close monitoring in diabetic patients.
Area of Science:
- Vascular Surgery
- Cardiovascular Disease Research
- Arteriosclerosis Treatment
Background:
- Arteriosclerosis poses a significant challenge in vascular disease management.
- Reconstructive surgery is a key intervention for affected limbs.
- Long-term outcomes and influencing factors require detailed investigation.
Purpose of the Study:
- To evaluate the long-term patency and survival rates following reconstructive surgery for arteriosclerosis.
- To identify factors influencing the success of surgical interventions.
- To assess mortality causes and their correlation with patient characteristics and comorbidities.
Main Methods:
- Retrospective analysis of 100 limbs from 79 patients undergoing reconstructive surgery for arteriosclerosis.
- Assessment of overall and long-term patency rates over 3 to 8 years.
- Correlation analysis between patency/survival rates and various clinical factors (hypertension, diabetes, cholesterol, age, etc.).
Main Results:
- Overall patency rate was 59% over 3-8 years.
- Long-term patency depended on run-off arteries, surgical site, and method.
- Survival rates were 62% at 5 years and 48% at 7 years, significantly lower than the general population.
- Mortality strongly correlated with hypertension severity, with cardiac and renal failure as primary causes.
Conclusions:
- Arteriosclerotic reconstructive surgery offers moderate long-term patency but is associated with poor survival.
- Hypertension is a critical factor affecting both patency and mortality.
- Aggressive reconstruction may be considered for WHO Stage 2 or lower hypertension, but vigilant cardiovascular monitoring is essential for diabetic patients.
Abstract:
Out of 769 patients with arterial diseases, reconstructive surgery was performed on 100 limbs of 79 patients for arteriosclerosis. The overall patency rate was 59 per cent over a period of 3 to 8 years. Long-term patency was influenced by the condition of the run-off arteries, the site of the operation, and the method of surgery. No relation was found between patency rate and hypertension, cardiac insufficiency, total serum cholesterol, diabetes mellitus, or age. The survival rate was 62 per cent at 5 years and 48 per cent at 7 years. These rates were significantly poor (p less than 0.001), compared with those in the normal population. Mortality was related to the degree of hypertension, with cardiac and renal failure being responsible for 72 per cent of deaths. Aggressive reconstruction may be indicated in cases with hypertension of stage 2 or below based on the WHO classification. However, especially in patients with associated diabetes mellitus close long-term observation of the cardiovascular system is necessary.