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[Femoropopliteal bypass in arteriosclerosis]

T Flørenes¹, W Zasada, S Bille

¹Kar/thoraxkirurgisk avdeling, Ullevål sykehus, Oslo.

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke

|November 10, 1994

Summary

Femoropopliteal bypass surgery is a key treatment for severe leg artery disease. While successful, outcomes vary, with above-knee bypasses showing better long-term patency than below-knee procedures.

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Area of Science:

Vascular Surgery
Cardiovascular Medicine

Background:

Femoropopliteal bypass operations are the primary treatment for severe arteriosclerosis in the femoropopliteal region.
Homologous veins and various prostheses are commonly used for these bypass procedures.

Purpose of the Study:

To evaluate the outcomes of femoropopliteal bypass operations performed between 1979 and 1988.
To compare the effectiveness of different graft materials and distal anastomosis placements.

Main Methods:

A retrospective analysis of 235 femoropopliteal bypasses performed over a 10-year period.
Graft types included reversed autologous vein (60%) and others; distal anastomosis was below the knee in 75% of cases.

Main Results:

Perioperative mortality was 2.1%, with 93% of operations initially successful.

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The overall five-year patency rate was 50.6%.

Distal anastomosis above the knee yielded significantly better patency rates compared to below-knee placement.

Conclusions:

Femoropopliteal bypass remains indicated for critical limb ischemia and severe claudication.
Graft choice and distal anastomosis location significantly impact long-term patency, with above-knee placement being superior.
No significant difference in patency was observed between reversed homologous vein and human umbilical vein grafts for below-knee bypasses.