A new method of angiographic runoff evaluation in femorodistal reconstructions. Significant correlation with early graft patency
S. Karacagil, B. Almgren, S. Bowald and I. Eriksson
Department of Surgery, University Hospital, Uppsala, Sweden.
In 62 patients undergoing femorodistal bypass surgery, the foot vessel
runoff was analyzed with a new grading system based on intraoperative
postreconstruction serial angiography. The patients were divided into two
groups according to the level of the distal anastomosis (proximal or low).
Good runoff was defined as integrity of the anterior and/or posterior foot
arch in proximal femorodistal grafts and integrity of both arches in low
bypasses. In the proximal group, runoff was classified as poor when the
arches were deficient or occluded, and in the low group, when only one arch
was intact. The patency rate after 6 months was 81% in the good runoff
group, whereas all grafts in patients with poor runoff were occluded. The
new method allowed better prediction of the early outcome than does the
primary and secondary pedal arch integrity concept.
