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  • Title: [The treatment of failed low limb prosthetic graft bypass for the chronic low limb ischemia: a report of 19 cases].
    Author: Ye W, Liu CW, Guan H, Liu B, Li YJ, Zheng YH, Wang S.
    Journal: Zhonghua Wai Ke Za Zhi; 2006 Aug 01; 44(15):1040-3. PubMed ID: 17074241.
    Abstract:
    OBJECTIVE: To determine the optimal strategies of occluded prosthetic bypass and to assess the risk factors which influence the outcome. METHODS: From September 2003 to December 2004, 19 cases of failed low limb prosthetic graft were treated in the Peking Union Medical College hospital. All of them underwent operation, and the strategies of operation were determined by the cause assessed pre-procedure. Four cases underwent thrombectomy only, 5 cases underwent thrombectomy combined with the distal anastomosed-plasty, 3 cases underwent thrombectomy combined with profundaplasty, 2 cases underwent vascular re-construction with new prosthetic graft, 1 case underwent external iliac artery endarterectomy, 2 cases underwent stent cell transplantation, and the last 2 cases underwent amputated since the limbs showed un-salvageable. All the cases got at least 1 year following-up. RESULTS: In the 17 vascular reconstruction cases except the 2 cases who underwent amputated, 14 cases (82.4%) got firstly successes, according to their limb ischemia symptom got well, but the rest 3 cases (17.6%) failed. And the mortality is 10.5% (2 cases). In the 1 year following-up, the prosthetic graft patency was 35.3% (6 cases), and the limb salvage was 76.4% (13 cases). CONCLUSION: Optimal resolution for prosthetic graft re-occlusion should be based on good judgment of the occlusion cause. Then proper correcting the cause plus right following-up program could be the risk factors of prognosis.
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