RESUMO
AIM: to determine the scope of infrainguinal revascularization of the limb in patients with multilevel lesions of arteries in chronic critical lower limb ischaemia (CCLLI). MATERIAL AND METHODS: A retrospective analysis of graft patency and limb salvage included a total of 76 patients undergoing a total of 78 bypass procedures consisting of: 1) two-level infrainguinal reconstructions (n = 35), 2) femoral-tibial (n = 36) and femoralplantar (n 7) bypass procedures. All patients had an isolated segment, of the popliteal artery in a combination with bifurcation arterial occlusive disease. Autovenous reversed retrograde and orthotopic in (situ vein grafts were used. All patients underwent intraoperative haemodynamic measurements. Graft patency was assessed by Doppler monitoring. The two groups studied were compared by demographic features and risk factors by means of the Student's and chi-squared tests. RESULTS: Life-table analysis showed demonstrated that two-level infrainguinal reconstructions provided better primary 3-year patency (76.2%) as compared with femoral-tibia! and plantar bypasses (60.4%, p<0.05). Intraoperative mortality occurred in 2 patients (2.5%). Early and mid-term thromboses appeared to be most frequently encountered in the group of femoral-tibial, and plantar reconstructions (18.6% vs 11.4%, p<0.38 and 30.8% vs 10.3%, p=0.04, respectively). CONCLUSION: Two-level infrainguinal arterial reconstruction in patients with CCLLI is an acceptable procedure alternative providing better graft patency higher limb salvage rate as compared with femoral-tibial or femoroplantar bypass.
