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Comparison of Hemodynamic and Clinical Results

David C. Brewster, MD; Peter M. Charlesworth, MD; JoAnne E. Monahan, RN; William M. Abbott, MD; R. Clement Darling, MD

Arch Surg. 1984;119(7):775-779.

Abstract
• Clinical and hemodynamic results of isolated popliteal segment, tibial, and sequential bypass grafts were compared in a retrospective review. Results were good with vein grafts to either an isolated segment or infrapopliteal vessel, with five-year patency rates of 71% and 72%, respectively. Prosthetic grafts performed poorly in both groups, and sequential grafts appeared advantageous in such circumstances. Average ankle pressure increased 49 mm Hg following successful isolated segment grafts. Although less than with patent tibial or sequential grafts, improvement was sufficient to relieve rest pain in all instances and heal ischemic lesions or local amputations in all but four patients. If an adequate vein is available and a good tibial vessel exists, distal grafting may be elected, particularly if advanced ischemic lesions demand restoration of pulsatile flow to the foot. If such conditions are not present, isolated segment grafting will give highly satisfactory results.

(Arch Surg 1984;119:775-779)

Author Affiliations
From the General Surgical Services, Massachusetts General Hospital and the Department of Surgery, Harvard Medical School, Boston.

Footnotes
Accepted for publication Feb 15, 1984.

Read before the tenth annual meeting of the New England Society for Vascular Surgery, Bretton Woods, NH, Sept 30, 1983.

Reprint requests to 1 Hawthorne Pl, Boston, MA 02114 (Dr Brewster).

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