The Relation between Distal Runoff and Clinical Outcome after Aorto-iliac Reconstruction Surgery.
- Author:
Hyangkyoung KIM
1
;
Yong Pil CHO
;
Ki Myung MOON
;
Tae Won KWON
Author Information
1. Division of Vascular Surgery, Department of Surgery, Asan Medical Center,University of Ulsan College of Medicine, Seoul, Korea. twkwon2@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Aorto-iliac occlusive disease;
Runoff score;
Graft patency
- MeSH:
Angioplasty;
Endarterectomy;
Extremities;
Femoral Artery;
Follow-Up Studies;
Humans;
Ischemia;
Proportional Hazards Models;
Retrospective Studies;
Stents;
Transplants
- From:Journal of the Korean Society for Vascular Surgery
2008;24(1):25-29
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We sought to evaluate the relationship between distal runoff and long-term graft patency in aorto-iliac occlusive disease. METHOD: A retrospective review was performed on 192 patients with aorto-iliac occlusive disease who underwent surgery between September 1995 and November 2005. Patients who underwent percutaneous angioplasty or stent placement were excluded. Preoperative angiograms were scored according to the SVS/ISVS Ad Hoc Committee guidelines. RESULT: The mean duration of follow-up was 50 months. Procedure indications consisted of claudication in 68 patients and critical limb ischemia in 124 patients. Procedures included 176 bypasses (50 aorto-iliac/aorto-femoral, 32 ilio-femoral, 46 axillo-femoral, and 48 femoro-femoral) and 16 endarterectomies with patch angioplasty. Overall 5-year patency rate was 84.1%. Higher primary patency was observed when the occlusion score of the superficial femoral artery (SFA) or deep femoral artery (DFA) was lower than 2 (P<0.05). Cox proportional hazard model showed run-off resistance values to be significant determinants of graft patency (p=0.000, Exp(B)=1.236). The group that underwent profundoplasty had significantly better long-term patency (P=0.009). CONCLUSION: Poor distal runoff score was related to lower primary patency. In patients with aorto-iliac occlusive disease and poor distal outflow, profundoplasty can improve primary patency.
