Abstract
Sixty-two bypass grafts to the peroneal artery were performed at the University of Rochester Medical Center between 1984 and 1990. An autogenous conduit was used in 45 patients and a prosthetic conduit in 17 patients. Primary cumulative patiency rates were 49% at two years and 30% at four years following operation. Limb salvage was achieved in 68% of patients. The two year cumulative patency rate was significantly better when the peroneal artery was of good quality arteriographically compared with those in which stenoses were present (75% versus 25%, p<0.05); in patients without inflow disease compared with patients with inflow disease (56% versus 11%, p<0.05); and in saphenous vein grafts compared with prosthetic grafts (55% versus 17%, p<0.05). The factors that did not influence patency were the presence of a direct peroneal collateral vessel filling a pedal vessel, age, sex, diabetes, and the size of the peroneal artery. The results of peroneal artery bypass in end-stage patients are dependent on the presence of adequate autogenous vein and a recipient peroneal vessel free of disease. Under these circumstances, the results of the procedure approach that of standard femorotibial reconstruction.
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References
DARDIK H, IBRAHIM IM, DARDIK II. The role of the peroneal artery for limb salvage.Ann Surg 1979;189:189–198.
KARMODY AM, LEATHER RP, SHAH DM, et al. Peroneal artery bypass: a reappraisal of its value in limb salvage.J Vasc Surg 1984;1:809–816.
O'MARA CS, FLINN WR, NEIMAN HL, et al. Correlation of foot arterial anatomy with early tibial bypass patency.Surgery 1981;89:743–752.
IMPARATO AM, KIM GE, MADAYAG M, et al. Angiographic criteria for successful tibial arterial reconstructions.Surgery 1973;74:830–838.
KARACAGIL S, ALMGREN B, BOWALD S, et al. A new method of angiographic runoff evaluation in femorodistal reconstructions.Arch Surg 1990;125:1055–1058.
DARDIK H, IBRAHIM IM, SUSSMAN B, et al. Morphologic structure of the pedal arch and its relationship to patency of crural vascular reconstruction.Surg Gynecol Obstet 1981;152:645–648.
BERGAMINI TM, TOWNE JB, BANDYK DF, et al. Experience with in situ saphenous vein bypasses during 1981 to 1989: determinant factors of long-term patency.J Vasc Surg 1991;13:137–149.
CORSON JD, KARMODY AM, SHAH DM, et al. In situ vein bypasses to distal tibial and limited outflow tracts for limb salvage.Surgery 1984;96:756–763.
RICCO JB, FLINN WR, MC DANIEL MD, et al. Objective analysis of factors contributing to failure of tibial bypass grafts.World J Surg 1983;7:347–352.
BUCHBINDER D, ROLLINS DL, SEMROW CM, et al. In situ tibial reconstruction, state-of-the-art or passing fancy.Ann Surg 1988;207:184–188.
SHAH DM, CHANG BB, FITZGERALD KM, et al. Durability of the tibial artery bypass in diabetic patients.Am J Surg 1988;156:133–135.
BLOOM RJ, STEVICK CA. Amputation level and distal bypass salvage of the limb.Surg Gynecol Obstet 1988;166:1–5.
Veterans Administration Cooperative Study Group 141. Comparative evaluation of prosthetic, reversed, and in situ vein bypass grafts in distal popliteal and tibial-peroneal revascularization.Arch Surg 1988;123:434–438.
BERGAN JJ, VEITH FJ, BERNHARD VM, et al. Randomization of autogenous vein and polytetrafluoroethylene grafts in femoral-distal reconstruction.Surgery 1982;91:921–929.
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Shortell, C.K., Ouriel, K., DeWeese, J.A. et al. Peroneal artery bypass: A multifactorial analysis. Annals of Vascular Surgery 6, 15–19 (1992). https://doi.org/10.1007/BF02000661
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DOI: https://doi.org/10.1007/BF02000661