Functional failure of patent femorodistal in situ grafts

Richard J. Fowl, Robert B. Patterson, Rosalie J. Bodenham, Richard F. Kempczinski

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

We have treated several patients who required major, proximal extremity amputations despite a patent infrainguinal in situ saphenous vein bypass graft. To determine those factors predisposing to such paradoxical limb loss, we studied a group of 45 patients who underwent 48 in situ, femorodistal bypass grafts for tissue necrosis and who maintained a patent graft throughout the perioperative period. Within this cohort, we compared two distinct subgroups: Group I, whose limbs (n = 8) ultimately required a major proximal amputation; Group II, whose limbs (n = 40) emerged with a viable foot and did not require a major amputation. There was no significant difference in the incidence of diabetes, renal failure, smoking, or postoperative ankle/brachial index between the two groups. The presence of gangrene (88% vs 45%), invasive sepsis (63% vs 23%), and combined gangrene and sepsis (63% vs 18%) was significantly (p < 0.05) more prevalent in Group I versus Group II. Forty-three percent of patients with both gangrene and foot sepsis required a major proximal amputation despite a patent graft. Such patients are at high risk for limb loss even if they undergo successful revascularization.

Original languageEnglish (US)
Pages (from-to)200-204
Number of pages5
JournalAnnals of Vascular Surgery
Volume3
Issue number3
DOIs
StatePublished - 1989

Fingerprint

Amputation
Extremities
Gangrene
Transplants
Sepsis
Foot
Ankle Brachial Index
Perioperative Period
Saphenous Vein
Causality
Renal Insufficiency
Necrosis
Smoking
Incidence

Keywords

  • Femorodistal bypass grafts
  • grafts
  • saphenous vein grafts

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Fowl, R. J., Patterson, R. B., Bodenham, R. J., & Kempczinski, R. F. (1989). Functional failure of patent femorodistal in situ grafts. Annals of Vascular Surgery, 3(3), 200-204. https://doi.org/10.1007/BF03187393

Functional failure of patent femorodistal in situ grafts. / Fowl, Richard J.; Patterson, Robert B.; Bodenham, Rosalie J.; Kempczinski, Richard F.

In: Annals of Vascular Surgery, Vol. 3, No. 3, 1989, p. 200-204.

Research output: Contribution to journalArticle

Fowl, RJ, Patterson, RB, Bodenham, RJ & Kempczinski, RF 1989, 'Functional failure of patent femorodistal in situ grafts', Annals of Vascular Surgery, vol. 3, no. 3, pp. 200-204. https://doi.org/10.1007/BF03187393
Fowl, Richard J. ; Patterson, Robert B. ; Bodenham, Rosalie J. ; Kempczinski, Richard F. / Functional failure of patent femorodistal in situ grafts. In: Annals of Vascular Surgery. 1989 ; Vol. 3, No. 3. pp. 200-204.
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