J.Jpn. Surg. Soc.. 85(6): 573-579, 1984

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Original article

THE EFFECTS OF FAILURE OF ARTERIAL RECONSTRUCTION ON LIMB STATUS

During the last 8 years, arterial reconstructive operations such as bypass grafting, thrombendarterectomy and percutaneous transluminal angioplasty were performed on 282 lower extremities with chronic arterial occlusion.
Operative indications were intermittent claudication in 57.1 % and limb salvage in 42.9%.
Early and late failure rate following operations was 31.2%: for claudication group 24.0% and for limb salvage group 40.7%. In 30.6% of claudication group and in 45.7% of limb salvage group, ischemia of limbs, compared to their preoperative status, worsened following occlusion. These limb worsening-rates were high and not negligible.
Main causes of failures were poor run off and poor graft.
Because chronic arterial occlusion is not an malignant disease, it is not forgivable to worsen limb status by surgery. Therefore, the operative indication for claudicant should be the need of patients in their daily life. For femoro-popliteal bypass grafting in claudicant, not artificial graft but auto vein graft should be used. When no suitable vein is available, conservative therapy is the choice of treatment. In case of limb salvage, artificial graft may be used.

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