Prognostic Indicators in Femoropopliteal Reconstructions

Dean, Richard H.

doi:10.1001/archsurg.1975.01360170027003

Cited by 100 publications

(11 citation statements)

References 14 publications

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“…The sixth patient (9) in this group was only 43 years old but had previously undergone aortocoronary bypass and aortofemoral bypass and left femoropopliteal bypass graft for symptomatic atherosclerotic disease. When symptoms of severe pain, numbness and coldness returned in the left leg, he did not seek medical attention for three days, at which time no pulses were detectable in the left leg.…”

Section: Resultsmentioning

confidence: 99%

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Thrombolytic Therapy in Severe Arterial Insufficiency With Absent Distal Pulses

Long

1982

Vascular Surgery

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Streptokinase therapy was used in 16 patients with severe ischemia of the limbs with undetectable ankle or wrist pressures. All patients had symptoms at rest with neurological deficits and the thrombolysis was considered an alternative to amputation. Limb salvage was achieved in 13 patients with 15 usages. Thrombolytic therapy was useful primarily as an adjunct to surgical therapy and was effective in lysing clots in small arteries not amenable to surgical methods. Thrombolysis was effective in relieving ischemic pain and in restoring pedal pulses in most instances. Streptokinase was used safely preoperatively, intraoperatively and postoperatively.

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Section: Resultsmentioning

confidence: 99%

“…7,8,9 When ankle pressures are undetectable with a Doppler probe, arterial reconstruction or lumbar sympathectomy usually are of little value in limb salvage. Early graft failure is common in patients with an ankle-brachial pressure index of less than 0.…”

Section: Introductionmentioning

confidence: 99%

Thrombolytic Therapy in Severe Arterial Insufficiency With Absent Distal Pulses

Long

1982

Vascular Surgery

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“…Dean et al observed that the limbs showing less than 0.2 of a preoperative Doppler ankle/brachial index (ABI) were associated with 91 % early failure rate after surgery, but they failed to correlate a preoperative ABI with a long-term patency of the reconstructed artery.' 7 Likewise, Corson et al reported that there was no relationship between a preoperative ABI and prognosis of the reconstructed artery.' At present, the prediction of outcome for the reconstructed artery, based on preoperative ABI, is impossible.…”

Section: Discussionmentioning

confidence: 99%

A New Assessment of Arteriographic Runoff for Predicting Fate of Femoropopliteal Arterial Reconstructions

et al. 1990

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The preoperative arteriogram has been widely used to estimate distal vascular runoff in reconstructions of the lower extremity arteries. Based on the authors' previous reports that the intraoperative electromagnetically determined flow waveform of the reconstructed artery is a reliable predictor for the prognosis of the reconstructed artery, the correlation between intraoperative flow waveform pattern and preoperative arteriographic runoff in 60 femoropopliteal arterial reconstructions was analyzed. Preoperative arteriographic runoff was classified into five groups (Groups A, B, C, D, and E), according to presence of continuity of the popliteal artery with the calf arteries and the number of patent calf arteries and of patent calf arteries connecting the pedal arch. Arteriographic runoff with Type 0 or I flow waveform (n = 34) showed that two or three calf arteries were patent to the ankle and that at least two had continuity to the pedal arch (Groups A and B). On the contrary, the arteriograms showing Type II flow waveform (n = 26) revealed a variety of distal runoff from one patent calf artery connecting with the pedal arch to the isolated popliteal artery (Groups C, D, and E). Arteriographic runoff of two groups of flow waveform 0/I vs II could be clearly distinguished. These results were taken to mean that continuity of patent calf arteries with the pedal arch can serve as an important factor for evaluating vascular distal runoff in femoropopliteal arterial reconstructions. The authors' assessment of arteriographic runoff is a simple preoperative predictor for intraoperative flow waveform, namely, the outcome, of the reconstructed artery.

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“…Artificial vascular grafts are often used as bypasses for longdistance arteries occluded due to atherosclerosis (Dean et al, 1975). However, thrombosis is still a major cause of failure in synthetic vascular grafts, especially for bypasses of small diameter arteries, e.g.…”

Section: Introductionmentioning

confidence: 99%