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Sequential bypass for multisegmental occlusive disease

K Fujioka1, N Akiyama, K Yoshimura

  • 1First Department of Surgery, Yamaguchi University School of Medicine, Japan.

Surgery Today
|January 1, 1993
PubMed
Summary
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Sequential bypass grafts effectively treat multisegmental occlusive disease, improving limb salvage and ankle-brachial index. Midterm results show promising graft patency rates for patients with severe peripheral artery disease.

Area of Science:

  • Vascular Surgery
  • Peripheral Artery Disease
  • Reconstructive Surgery

Background:

  • Multisegmental occlusive disease presents a significant challenge in vascular surgery.
  • Sequential bypass grafting offers a potential solution for complex arterial blockages.

Purpose of the Study:

  • To evaluate the effectiveness of sequential bypass grafting for treating multisegmental occlusive disease.
  • To assess graft patency and clinical outcomes in patients undergoing these procedures.

Main Methods:

  • A retrospective analysis of 47 sequential bypass grafts in 43 patients (age 55-83) with severe peripheral artery disease.
  • Procedures included anatomical and extra-anatomical bypasses, with follow-up ranging from 3 to 77 months.
  • Outcomes measured included graft patency, limb salvage, and changes in ankle-brachial index (ABI).

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Main Results:

  • The cumulative graft patency rate was 85% at one year and 65% at three years.
  • Mean preoperative ABI of 0.29 improved significantly to 0.97 post-surgery and 0.84 late post-op.
  • Twelve graft failures occurred, with 2 requiring major amputations, indicating a high rate of limb salvage.

Conclusions:

  • Multiple sequential bypass grafts are an effective treatment for multisegmental occlusive disease.
  • These procedures lead to significant improvement in limb perfusion and functional status.
  • Sequential bypasses demonstrate favorable midterm patency and limb salvage rates.