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A 15-Year Experience

George P. Kacoyanis, MD; Anthony D. Whittemore, MD; Nathan P. Couch, MD; John A. Mannick, MD

Arch Surg. 1981;116(12):1529-1534.

Abstract
• Results with 111 femoral-infrapopliteal vein grafts in 105 patients were subjected to life-table analysis. The overall five-year cumulative graft patency rate of 46% was associated with a 60% limb salvage rate. In cases in which the infrapopliteal graft represented the initial operative procedure, the five-year limb salvage and patency rates (69% and 56%, respectively) were significantly higher (P <.05) than those achieved with secondary grafts (38% and 22%, respectively). Most limbs (79%) with failed infrapopliteal grafts, without further attempts at reconstruction, required major amputation within six months. The site of the distal anastomosis (anterior tibial, posterior tibial, or peroneal arteries) proved not to be a significant factor in determining long-term limb salvage or graft patency rates. Furthermore, the differences between five-year salvage and patency rates in diabetics (45% and 32%, respectively) and nondiabetics (65% and 53%, respectively) approached but did not reach statistical significance. It is believed these observations support the established but controversial role of infrapopliteal bypass in advanced peripheral occlusive disease.

(Arch Surg 1981;116:1529-1534)

Author Affiliations
From the Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston.

Footnotes
Accepted for publication July 7, 1981.

Read before the 29th scientific meeting of the International Cardiovascular Society, Dallas, June 12, 1981.

Reprint requests to Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Mannick).

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