Femoropopliteal reconstruction for claudication. The risk to life and limb
K. C. Kent, M. C. Donaldson, C. E. Attinger, N. P. Couch, J. A. Mannick and A. D. Whittemore
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
The current study was undertaken to examine the results of femoropopliteal
bypass grafting with intermittent claudication as the indication. Of 1173
infrainguinal reconstructions carried out on our service during the past
decade, 249 (21%) consecutive femoropopliteal grafts were performed for
disabling claudication in 191 patients. The primary five-year cumulative
patency rates were 78% for autogenous vein and 52% for
polytetrafluoroethylene grafts. There were two (0.8%) 30-day operative
deaths and a subsequent five-year amputation rate of 2.4% for both groups.
Femoropopliteal reconstruction for claudication may therefore be carried
out with acceptably low operative mortality and a subsequent amputation
rate comparable with that anticipated from the natural history of the
disease. While the five-year patency rate is significantly higher utilizing
autogenous vein grafts, symptomatic relief may be expected with prosthetic
grafts in approximately half the patients without incurring a higher risk
of limb loss.
