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Aortic Reconstruction vs Extra-anatomic Bypass and AngioplastyThoughts on Evolving a Protocol for Selection
T. J. Bunt, MD
Arch Surg. 1986;121(10):1166-1171.
Abstract
• One hundred forty-eight patients were evaluated for inflow revascularization and stratified by age, vascular anatomy, medical history, and cardiac functional class into aortic reconstruction (AR), extra-anatomic bypass (EAB), or iliac angioplasty based on a protocol that restricted AR to good-risk patients and liberalized indications for EAB. Fifty-five patients underwent AR with a 1.8% mortality, 1.8% myocardial infarction and 12% morbidity, and cumulative life-table patency of 94% at two years; 69 patients underwent EAB with no mortality and negligible morbidity; cumulative life-table patency was 93% at two years for crossover femoral and 83% at two years for axillofemoral grafts. Operative selection based on a protocol restricting AR to better-risk patients and liberalizing use of EAB may decrease overall patient mortality and morbidity without jeopardizing limb preservation.
(Arch Surg 1986;121:1166-1171)
Author Affiliations
From the Department of Surgery, University of South Carolina School of Medicine, Columbia.
Footnotes
Accepted for publication April 4, 1986.
Reprint requests to Department of Surgery, University of South Carolina School of Medicine, 2 Richland Medical Park, Suite 402, Columbia, SC 29203 (Dr Bunt).
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