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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2006, Number 1

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Rev Mex Angiol 2006; 34 (1)

Infrainguinal derivations for lower limbs’ revascularization in patients with atherosclerosis in a three-year period at the National Medical Center XXI Century, IMSS

García PJ, Torres SNA, Rodríguez PL

Language: Spanish
References: 24
Page: 13-21
PDF size: 238.63 Kb.


ABSTRACT

Introduction: The infrainguinal bypass limbs are the treatment of election for patients with arterial insufficiency with claudication, critical isquemia and irreversibles lesions. The results at the beginning are favorable in 90% of cases as far as permeability, but the subsequent fault of the graft remains like a significant problem, existing discrepancy between the results of the studies reported in world-wide literature.
Objective of the study: To evaluate the results of grafts permeability and its complications in last three years in the patients with affectation of the femoropopliteal segment on infrainguinal arterial bypass by above and below the knee.
Material and methods: A retrospective, longitudinal, descriptive, cohorts study was made of March of the 2002 to March of 2005 in the patients with atherosclerosis and affectation of the femoropopliteal segment for bypass of revascularization by above Group A and below the knee Group B.
Results: They were a total of 65 patients, 45 men and 20 women, with an media years old 65.2 years. The comorbidity in addition to the atherosclerosis, were diabetes mellitus, smoking intense, dislipidemia, coronary disease and arterial hypertension between others. We used the Fontaine and Rutherford classifications for correlate the degree of severity of the affectation. The group A by above of the knee 23 patients divided itself in two sub-groups: seven (30.43%) were with inverse safena and 16 (69.56%) patient with PTFE. Group B below the knee 42 patients divided in four subgroups: inverse safena 19 (45.23%), PTFE eight (19%), safena in situ seven (16.66%) and mixed graft eight (19.04%).
Conclusions: The derivations with autologous graft of safena give to better permeability and minors complications that the synthetic grafts, as much by above as below the knee, a estadistic difference as far as permeability with autologous and synthetic grafts by above were of the knee. The complications with synthetic material PTFE are greater in immediate postoperating until the 30 days, in comparison with the autologous, as much by above as below the knee.


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