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Hemodynamic Improvement and Patency Rate

Andrew J. Lamerton, FRCS, MRCP; Andrew N. Nicolaides, MS, FRCS; Harold H. G. Eastcott, MS, FRCS

Arch Surg. 1985;120(11):1274-1278.

Abstract
• We measured the hemodynamic improvement after femorofemoral grafting and determined the five-year cumulative patency rate in 54 consecutive high-risk patients with unilateral iliac artery occlusion who had femorofemoral grafts who were studied with ankle and brachial systolic pressure measurements before and after operation and at six-month intervals. There were two early deaths and seven early graft failures (<30 days) with four amputations (all operated on for rest pain). All of the remaining 45 patients' conditions improved clinically and objectively. The resting pressure index (mean±SD) in claudicants (n=23) increased from 0.35±0.15 to 0.67±0.20; in patients with severe ischemia (n=31) it increased from 0.25±0.15 to 0.50±0.20. During the follow-up period (six months to ten years), there were eight deaths and 12 late graft failures (>30 days). The late cumulative patency rate was 60% at five years. Hemodynamic improvement parallels clinical success and for these high-risk patients, the femorofemoral bypass is a satisfactory alternative to a more major operation.

(Arch Surg 1985;120:1274-1278)

Author Affiliations
From the Irvine Vascular Laboratory (Dr Lamerton), Academic Surgical Unit (Professor Nicolaides), and Cardiovascular Unit (Dr Eastcott), St Mary's Hospital Medical School, London.

Footnotes
Accepted for publication April 9, 1985.

Presented at the Symposium on Extra-anatomic and Secondary Arterial Reconstruction, Charing Cross Hospital, London, September, 1982.

Reprint requests to "Trinity Lodge," 84 London Rd, Forest Hill, London SEZ3, England (Dr Lamerton).

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