OBJECTIVETo report the mid- to long-term outcome of artery bypass in chronic ischemia of lower extremities.

METHODSThe clinical data of 212 patients treated with bypass operation from January 2002 to April 2007 were retrospectively reviewed. Femoropopliteal artery bypass to above-knee popliteal (FP-ak) was carried out in 111 cases, femoropopliteal artery bypass to below-knee popliteal (FP-bk) in 59 cases, aortoiliac bypass in 25 cases and femorofemoral bypass in 17 cases.

RESULTSOne hundred and eighty-six patients (87.7%) were followed up for 6 to 68 months (median, 18 months). One-year primary patency rate of FP-ak and FP-bk was 69.7% and 53.5%, respectively. After graft revision, 1-year secondary patency rate of FP-ak and FP-bk were 81.6% and 60.5%, respectively. The 3-year patency with FP-ak (56.3%) was significantly higher than that in FP-bk (23.8%) (P < 0.05). Fifty-two cases were reoperated on during the follow-up period. Crural or femoral amputation could not avoid in 23 cases (limb salvage rate 89.2%). Ten cases died in 1 to 30 days after the operation, 20 cases died later during followup, and most of them died of cardio-cerebrovascular diseases. Artificial vessel infection occurred in 6 cases.

CONCLUSIONSThe selection of surgical treatment for chronic ischemia of lower extremities should based on the ischemic state of the limb. The mid- to long-term patency rate of FP-ak is higher than that of FP-bk.