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Arterial reconstruction to the foot arteries--a viable option?
1Surgical Department, Vasa Central Hospital, Finland.
Objective:
To analyse the outcome of arterial reconstruction to the foot arteries for chronic critical leg ischaemia.
Design:
Retrospective study.
Setting:
Regional hospital and academic referral centre in Finland.
Subjects:
99 patients who underwent 109 reconstructions to the foot arteries.
Main Outcome Measures:
Patency, leg salvage and survival.
Results:
Autogenous vein was used for the reconstruction in 91%. Two year patency of femoropedal and popliteopedal vein bypasses were 60% and 72% with similar rates of leg salvage. Prosthetic bypass had a low patency rate (20% at 2 years). Age, sex, diabetes and the condition of the outflow artery did not influence outcome. Survival of patients at 1, 2 and 3 years was 80%, 69% and 54%, respectively.
Conclusions:
Reconstructions to the foot arteries are demanding and have high immediate failure rates. If autogenous vein is used acceptable patency and leg salvage rates can be achieved. In old patients this may be enough to preserve mobility for the rest of their lives.