Long-term prognosis of femoropopliteal bypass: An analysis of 349 consecutive revascularizations
Long-term prognosis of femoropopliteal bypass: An analysis of 349 consecutive revascularizations
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DOI：
10.1046/j.1440-1622.2001.2122.x
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发表时间：
2001-06-01
影响因子：
1.7
通讯作者：
Cheng, SWK
中科院分区：
文献类型：
--
作者：
Lau, H;Cheng, SWK
背景：股腘动脉搭桥术是下肢血运重建最常见的手术。本研究的目的是确定股腘动脉搭桥术的长期结果，并评估各种临床因素对长期result.Methods的预后意义：从1976年至1998年，349个连续的主要股腘动脉搭桥手术进行了314例在香港大学医学中心。手术指征包括跛行（n = 85）和威胁肢体的缺血（n = 264）。对14个临床变量进行单因素和多因素分析，以确定影响移植物通畅率、保肢率和患者生存率的显著预后因素。结果：股腘动脉旁路术的总体一期通畅率在1年、3年和5年分别为88%、79%和76%。移植物材料类型和患者年龄是影响移植物通畅的独立预后因素。1年、3年和5年的累积保肢率分别为90%、86%和86%。没有临床因素被发现是预测最终肢体丧失。1、3、5年生存率分别为89%、85%、78%。冠心病是晚期死亡的主要原因。性别和手术指征是长期生存的显着预测因素。结论：股腘动脉旁路术使用反向长隐静脉提供了最持久的长期通畅。如有条件，应选择自体大隐静脉作为血管通路。男性和威胁肢体的缺血与生存率低相关。
Background: Femoropopliteal bypass is the commonest procedure for lower limb revascularization. The aim of the present study was to determine the long-term outcomes of femoropopliteal bypass and evaluate the prognostic significance of various clinical factors on the long-term results.Methods: From 1976 to 1998, 349 consecutive primary femoropopliteal bypass operations were performed on 314 patients at the University of Hong Kong Medical Centre. Indications for operation included claudication (n = 85) and limb-threatening ischaemia (n = 264). Univariate and multivariate analyses of 14 clinical variables were undertaken to identify significant prognostic factors affecting the graft patency, limb salvage and patient survival rates.Results: The overall primary patency rates of femoropopliteal bypass were 88%, 79% and 76% at 1, 3 and 5 years, respectively. Type of graft material and age of patient were independent prognostic factors of graft patency. The cumulative limb salvage rates were 90%, 86% and 86% at 1, 3 and 5 years, respectively. No clinical factor was found to be predictive of ultimate limb loss. The overall survival rates were 89%, 85% and 78% at 1, 3 and 5 years, respectively. Coronary artery disease was the main cause of late death. Gender and indication for operation were the significant predictive factors of long-term survival.Conclusions: Femoropopliteal bypass using reversed long saphenous vein provided the most durable long-term patency. Autologous saphenous vein should be the choice of vascular conduit if available. Male gender and limb-threatening ischaemia were associated with a poor survival.