Outcome of Ilio-Popliteal Grafting for Peripheral Arterial Disease

Abstract

Objective: Assess outcomes of ilio-politeal grafting for complex ilio-femoral atherosclerotic disease. Design: Retrospective review of patients undergoing iliopopliteal grafting between January 1998 and January 2007. Methods: Patients were identified from our unit database. Case notes and radiology were retrieved. Data were extracted and entered into the database for analysis. Results: 19 grafts were undertaken in 19 patients. Primary graft patency was 45% at 1 year (95% CI, 22% - 68%). Secondary graft patency was 82.5% at one year (95% CI, 64% - 100%). 25 subsequent surgical and radiological interventions were undertaken in 12 patients. Lower limb amputation was rare; limb survival was 88% (95% CI, 72% - 100%) at one year and 73% (95% CI 44% - 100%) at 4 years. Conclusions: Iliopopliteal grafts are rarely undertaken severe disease requiring their use is infrequently encountered. High mortality and low primary patency mean its use can only be advocated in exceptional circumstances.

Keywords

ilio-popliteal grafting outcome atheroscerosis ileo-femoral

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References

McCaslin J. , Hafez HM , Stansby G. Lower-limb revascularization and major amputation rates in England . Br J Surg. 2007;94(7):835-839.

Horton RE Iliopopliteal Dacron graft in treatment of advanced ischaemia of the leg. Ann R Coll Surg Engl. 1977;59(6):494-496.

Horton RE , Giddings AEB , Parkes AC Iliopopliteal Dacron grafts as an alternative to amputation. Ann R Coll Surg Engl. 1979;61(3):217-218.

Rutherford RB , Becker GJ Standards for evaluating and reporting the results of surgical and percutaneous therapy for peripheral arterial disease . J Vasc Interv Radiol. 1991;2(2):169-174.

Zukauskas G. , Ulevicius H. , Triponis V. Sequential aortofemoropopliteal/distal bypass for treatment of critical lower-limb ischaemia. Cardiovasc Surg. 1995;3(6):671-678.

Demasi RJ , Snyder SO , Wheeler JR , et al. Intraoperative iliac artery stents: combination with infra-inguinal revascularisation procedures. Am Surg. 1994 ;60(11):854-859.

Liu C. , Guan H. , Li Y. , Zheng Y. , Liu W. Combined intraoperative iliac artery stents and femero-popliteal bypass for multilevel atherosclerotic occlusive disease. Chin Med Sci J. 2001;16(3):165-168.