The effect of re-operation on postoperative arterial bypass occlusion in lower limbs / 中国普通外科杂志

ABSTRACT

Objective To review the experiences of re-operational effect for occluded arterial bypass in lower limbs. Method We analyzed the re-operational effect of 19 patients (20 limbs) with occluded arterial bypass in lower limbs from May 1996 to Fab 2004. A total of 31 operations were performed in these patients. Results The patent rate of simple thrombectomy in 18 cases was only 27.7% (5/18) with a rate of re-obstruction of 72. 3%(13/18). The period of patent outflow of another 13 re-operations with rebuilt of in-flow or out-flow varied at 4 days to 11 months. The patent rate in this group was 61.5% (8/13). The rate of re-obstruction was 38. 5% (5/13). The overall patent rate of re-operation was 41.9% (13/31). The average patent period was 9. 1 months (3-29 m). The operative mortality rate in 19 patients was 5. 3% (1/19). The limb salvage rate of 19 limbs in 18 patients was 73. 7%(14/19). The amputation rate was 25%(5/20). Conclusion The main cause of late re-obstruction of bypass procedure was endothelial proliferation and development of lesions. The effect of rebuilt of in-flow or out-flow was better than thrombectomy only. Duplex follow-up helps to find restenoses and manage the proliferated lesions before a bypass becomes occluded.