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[Revascularisation in the femoro-crural region (author's transl)]
Insights
This study evaluated femoro-crural revascularization for severe limb ischemia. Autogenous vein grafts showed good long-term patency and limb salvage rates, offering a viable treatment option.
Area of Science:
- Vascular Surgery
- Peripheral Artery Disease
Background:
- Severe limb ischemia (stage III-IV) often necessitates surgical intervention.
- Accurate diagnosis relies on lower extremity artery radiography and angiography.
Purpose of the Study:
- To assess the outcomes of femoro-crural revascularization procedures.
- To evaluate the efficacy of autogenous vein grafts in restoring lower extremity blood flow.
Main Methods:
- 132 femoro-crural revascularization operations were performed on 126 patients.
- Orthotopic reconstruction primarily utilized autogenous vein grafts.
- Radiography, angiography, and exploratory vascular operations guided surgical decisions.
Main Results:
- Immediate bypass patency was achieved in 93.9% of cases.
- At follow-up (2-9 years), 78.3% of bypasses remained patent.
- Good long-term results were observed in 64.4% of patients, with limb salvage rates also reported.
Conclusions:
- Femoro-crural revascularization with autogenous vein grafts is effective for treating severe limb ischemia.
- The procedure demonstrates favorable long-term patency and limb salvage.
- Surgical intervention is crucial for patients with advanced peripheral artery disease.
Abstract:
Femoro-crural revascularisation was performed in 132 operations in 126 patients. In 85.6% of these cases the operation was indicated because stage-III or stage-IV ischaemia was present. The necessity for surgery is determined by radiography of one artery of the lower extremity; in 31 of these patients it was necessary to perform a direct femoral puncture or an exploratory vascular operation followed by angiography. The authors' policy was to perform orthotopic reconstruction with autogenous vein grafts. In isolated cases a ring clearance or a prosthesis was used in the thigh region. Immediate patency was obtained in 93.9%. Of these operations, 120 were seen as follow-up; 78.3% of the bypasses were still patent, there was occlusion in 15 cases, and amputation was necessary in 11. Long-term results (2 to 9 years after the operation) were good in 64.4%.