Long-term results of reconstructive surgery for femoro-popliteal arterial occlusive lesions

Abstract

A retrospective review of 156 reconstructions performed for femoro-popliteal arterial occlusive lesions in 141 patients was carried out in terms of the reconstructive procedure and the degree of out-flow in the distal vessel. The cumulative patency rate for 95 autogenous vein grafts was 60.7 per cent at 12 years and higher than the 27.4% patency rate for 50 endarterectomies (p less than 0.001). All of 11 synthetic bypass prostheses failed with late thrombosis within 3 years after operation. The cumulative patency rate in cases with good distal run-off vessel and those with fair distal run-off vessel were 77.1% at 11 years and 57.3% at 12 years, respectively, and these values were significantly superior to 10.3% in cases with poor distal run-off vessel. The patency rate for 41 in situ grafts was 72.2%, being superior to 65.5% for 42 free grafts.

Pathophysiological features of intimal hyperplasia of the arterially implanted autovein graft and its anastomosis in dogs

“…Autogenous vein bypass grafting is a suitable procedure for peripheral arterial reconstruction [1][2][3][4][5]. However, late graft occlusion caused by progressive intimal hyperplasia of the vein graft and/or at the distal end-to-side anastomosis has occurred in about 30% of cases with poor distal outflow, Correspondence to: Tsutomu Kawabata, M.D., Second Department of Surgery, Faculty of Medicine, University of' the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa 903-01, Japan 1-3 years after grafting [6][7][8][9]. Shrestha et al [10] pointed out that intimal hyperplasia of the implanted autovein graft was related to active proliferation of smooth muscle cells at the graft and of fibroblast-like cells at the distal end-to-side anastomosis.…”