Clinical Analysis of Femoropopliteal Bypass

Lee, Hun Hyo; Moon, In Sung; Park, Jang Sang; Kim, Seung Nam; Koh, Yong Bok

Abstract

The femoropopliteal arterial bypass is one of the most widely used vascular procedures for arterial reconsturctions of infrainguinal region. We performed 71 femoropopliteal bypass operations in 54 patients from January 1993 to December 1995 at the Dept. of surgery, Kangnam St. Mary's Hospital in Catholic University Medical College. We reviewed these patients retrospectively with admission and out paient charts with following results. 1) Most of patients were male in 50(92.6%) with peak incidence in the seventh decade 29(53.7%). 2) The etiologies were artherosclerosis obliterans(ASO) in 92.6% and thromboangitis obliterans(TAO) in 7.4%. 3) The associated diseases were 31 hypertensions (57.4%), 18 diabetes mellitus(33.3%), 3 chronic renal failures(5.6%), 2 abdominal aortic aneurysms(3.7%) and 2 cerebrovascular accidents(3.7%). 4) We used PTFE(polytetrafluoroethylene) synthetic graft in 65 cases and autogenous saphenous vein in 7 cases for graft material. 5) The inflow procedures were performed simultaneously in 36 cases(50.7%), which were 26 aortobifemoral bypasses, 7 iliofemoral bypasses, 2 AAA(abdominal aorta aneurysm) repairs and 1 aortobiliac bypass. The additional outflow procedures were performed in 6 cases; 4 Taylor's patches and 2 Miller's cuffs. 6) The primary patency rate at six months 93.3%, one year 87.3%,two years 68.3%, three years 48.8% and the secondary patency rate at six months was 93.8%, one year 87.3%, two years 71.2%, three years 61.1. 7) The complications after bypass were 6 wound problems, 3 major amputations, 1 lymphatic leakage, but there were no death cases.Even though our primary patency rate of the femoropopliteal bypass was somewhat poorer than that of reported foreign data, we could find secondary patency rate was acceptable with others by aggressive vascular approaches. After femoropopliteal bypass, even consecutive below knee vascular reconstruction, poor vasculatures were seemed to be the leading cause to major amputations and toe amputations. Further clinical study should be followed in the future.