Abstract:
:Reported patency rates for paramalleolar bypass grafts have varied widely. To determine factors predictive of outcome, we reviewed our experience with 80 consecutive paramalleolar reconstructions in 68 patients performed between December 1986 and May 1995. All procedures were performed for critical limb ischemia defined as nonhealing ulcer or gangrene (n = 72, 90%) and rest pain (n = 8, 10%). Risk factors present were diabetes (n = 52, 65%), hypertension (n = 64, 80%), and history of smoking (n = 57, 71%). Of the 80 bypasses, in situ saphenous vein conduits were used in 39 (49%). In the remainder non-in situ grafts were used including reversed vein (n = 25, 31%), composite vein (n = 11, 14%), polytetrafluoroethylene (PTFE; n = 4, 5%), and composite PTFE/vein (n = 1, 1%). The recipient vessel was the dorsalis pedis artery in 26 procedures (33%), the posterior tibial artery in 32 (40%), the distal anterior tibial artery in 18 (22%), and tarsal or plantar vessels in four (5%). Primary and secondary patency rates were 52% and 68% at 36 months, respectively, by life-table analysis. The limb salvage rate was 86% and patient survival was 56% at 36 months. Secondary patency was significantly higher in diabetic patients than in their nondiabetic counterparts (86% vs. 50% at 36 months, p < 0.03). Similarly, patients undergoing in situ reconstructions had better secondary patency than patients with non-in situ conduits (86% vs. 51% at 36 months, p = 0.03). Diabetic patients tended to be younger (median age 69 years vs. 72 years) and had fewer prior reconstructions (7 [13%] vs. 13 [46%], p < 0.01). Diabetic patients received a higher proportion of in situ reconstructions (54% vs. 39%) but the difference did not achieve statistical significance (p = 0.09). We conclude that the long-term patency for paramalleolar bypass is acceptable but inferior to reported figures for more proximal reconstructions. The factors that most influence patency are the quality of the venous conduit and the presence of diabetes. The improved patency seen in diabetic patients is likely related to the fact that these patients require paramalleolar bypass at an earlier age, are less likely to have had previous reconstructions, and are therefore more likely to have a good quality venous conduit.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Plecha EJ,Lee C,Hye RJdoi
10.1007/BF02286779subject
Has Abstractpub_date
1996-07-01 00:00:00pages
356-60issue
4eissn
0890-5096issn
1615-5947pii
S0890-5096(06)62092-Xjournal_volume
10pub_type
杂志文章abstract::Thrombotic complications associated with coronavirus disease 2019 (COVID-19) have been described; these have mainly included venous thromboembolic events. Limited literature is available regarding arterial thrombosis. Acute limb ischemia is associated with severe complications that can result in significant morbidity ...
journal_title:Annals of vascular surgery
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更新日期:2021-01-01 00:00:00
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doi:10.1016/j.avsg.2013.06.017
更新日期:2014-01-01 00:00:00
abstract::Spontaneous venous aneurysms of the upper extremities and neck are rare and typically asymptomatic. We present the first reported case of a symptomatic, primary upper extremity venous aneurysm in a patient who initially presented with pulmonary emboli. A 22-year-old patient was admitted with chest pain, dyspnea, and a...
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更新日期:2013-02-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900043
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Takayasu arteritis (TA) is a rare, systemic, inflammatory vasculitis of granulomatous nature, and still of unknown etiology. It mainly involves the aorta and its major branches and is more commonly seen in women of childbearing age and Asians. TA leads to stenosis, occlusion, or aneurysmal degeneration of la...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.02.011
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Registry studies have shown that the Endurant stent graft is associated with low rates of all-cause and aneurysm-related mortality when used for the endovascular treatment of abdominal aortic aneurysm (AAA). However, many were limited by length of follow-up and all had a proportion of patients lost to follow...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.02.020
更新日期:2020-08-01 00:00:00
abstract::Diagnosis of prosthetic vascular graft infection (PVGI) is a clinical challenge requiring accurate diagnostic methods for their optimal management. A 65-year-old patient with suspected PVGI was explored by fluorodeoxyglucose positron emission tomography combined with computed tomography ((18)F-FDG PET-CT) for pretreat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.03.053
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:We performed a systematic review and meta-analysis to examine whether patients with intermittent claudication can benefit from endovascular treatment (EVT). METHODS:A prespecified search strategy was used to identify relevant studies in the MEDLINE, Embase, and Cochrane databases. A total of 10 different ra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.avsg.2013.05.022
更新日期:2014-05-01 00:00:00
abstract::A 10 year retrospective study of 103 patients with amaurosis fugax was done. Sixty-two patients with symptoms of amaurosis fugax underwent arteriography, which demonstrated ulcerated carotid plaque in 36 and hemodynamically significant stenoses (greater than 75% diameter reduction) in 26. These 62 patients underwent c...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000275
更新日期:1992-05-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60700-0
更新日期:1986-05-01 00:00:00
abstract:BACKGROUND:Significant national variation exists in defining the degree of stenosis that requires intervention in patients with asymptomatic carotid artery stenosis (ACAS). We aimed to evaluate the risk of perioperative and 2-year stroke and death in ACAS patients undergoing carotid endarterectomy (CEA) and carotid art...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.10.001
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Type Ia endoleak may lead to continuous sac pressurization and late rupture after endovascular aneurysm repair (EVAR). Nevertheless, there have been scarce reports suggesting that these endoleaks may occasionally present spontaneous sealing. Taking into account the original sealing mechanism of the Ovation e...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.04.041
更新日期:2019-01-01 00:00:00
abstract::This study reports our experience of using thoracoscopic cervicodorsal sympathectomy with diathermy. From December 1994 to September 1998, we performed 53 thoracoscopic sympathectomies in 35 patients. There were 15 men and 20 women, ages 18 to 61 years. Ten surgeries were performed on the right side, 7 were the left, ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900302
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to explore the impact of surgeon characteristics (including annual volume, specialty, and years in practice) on outcomes of carotid endarterectomy (CEA) for asymptomatic carotid atherosclerosis in New York State. METHODS:The New York Statewide Planning and Cooperation System dat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.05.015
更新日期:2017-11-01 00:00:00
abstract::Takayasu's arteritis (TA) is a systemic large vessel vasculitis that affects the aorta and its branches. Most patients with TA respond to medical therapy with a minority of patients requiring surgical intervention. In our report, we describe the case of a 59-year-old Caucasian female with TA who underwent revasculariz...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.09.019
更新日期:2020-02-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000502
更新日期:1990-07-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2015.03.055
更新日期:2015-10-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.02.004
更新日期:2009-03-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.046
更新日期:2011-11-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.014
更新日期:2019-10-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.10.035
更新日期:2013-11-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.04.006
更新日期:2013-02-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900286
更新日期:1999-09-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900091
更新日期:1997-11-01 00:00:00
abstract::An 8-year retrospective review of Indiana University Hospital records consisting of any patient age 18 to 40 years old who presented with arterial mesenteric ischemia was performed. Three patients were identified that met our criteria. The first patient was discovered to have a protein C deficiency. The second patient...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0305-3
更新日期:2003-05-01 00:00:00
abstract::True aneurysms and pseudoaneurysms of the visceral arteries are uncommon. Visceral artery aneurysms (VAAs) represent 0.1-0.2% of all vascular aneurysms and were also found in 0.1% of autopsies. VAAs most commonly affect the splenic (60%), hepatic (20%), and superior mesenteric (9%) arteries. Mesenteric injury caused b...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.09.006
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Risk factors for early catheter-directed intra-arterial thrombolysis failure in acute lower limb ischemia remain unclear. METHODS:One hundred forty-nine limbs with acute artery or bypass graft thrombosis underwent catheter-directed thrombolysis (maximum of 48 hours). A retrospective data analysis was carrie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.11.016
更新日期:2014-01-01 00:00:00
abstract::The aim of this study was to describe the results of resection and graft replacement for type III and IV thoracoabdominal aortic aneurysm repair. In this retrospective study, 27 patients underwent resection and graft replacement for type III (10) or type IV (17) thoracoabdominal aortic aneurysms. Nine patients had rup...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0048-z
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Our goal was to analyze the incidence and risk factors for 30-day postdischarge mortality in patients with vascular disease undergoing major lower extremity amputation. METHODS:We queried the American College of Surgeons National Surgery Quality Improvement Program data set from the years 2005 to 2009 for a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.05.012
更新日期:2012-02-01 00:00:00
abstract::Bier spots represent a benign vascular mottling characterized by multiple irregular white macules along the extensor surfaces of the arms and legs. They have been reported in a variety of diverse conditions with no consistent disease association. We have identified a novel association between these physiologic anemic ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2014.07.005
更新日期:2014-11-01 00:00:00