PMID: 8971579Sep 1, 1996Paper

Completion arteriography in paramalleolar bypasses: effect of configurational changes, with special reference to spasm, on long-term outcome

International Angiology : a Journal of the International Union of Angiology
O SatoY Tada

Abstract

The purpose of this study was to ascertain the durability of paramalleolar bypasses and elucidate the effect of configurational changes, especially spasm, seen on the completion arteriography upon the outcome. Retrospective study. University hospital experience. Nineteen paramalleolar bypass operations in sixteen patients performed between April 1988 and March 1995 were studied retrospectively. Reversed saphenous vein grafts were used in all cases. One patient required an additional microvascular free flap transfer to cover a foot amputation stump. Seventeen completion arteriograms were obtained. Patients were followed for an average of 37 months. One patient died in hospital, giving a hospital death rate of 5.9%. Two grafts failed immediately and could not be salvaged. Inadvertent perforation of one graft required partial replacement with a polytetrafluoroethylene graft; it eventually failed after 42 months. There were no other graft failures during follow-up. Nine completion arteriograms showed spastic change of the run-off artery, but this change had disappeared on repeat angiograms obtained before discharge. Spasm of run-off artery is a frequent finding in distal bypass surgery and adversely affects the immediate outcome. H...Continue Reading

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