LONG-TERM SURGICAL OUTCOME OF LATE AORTO-FEMORAL GRAFT OCCLUSIONS IN PATIENTS WITH RECURRENT LOWER LIMB ISCHEMIA

Yu.E. Voskanyan, A.V. Vyrvyhvost, Yu.P. Tatsij, O.I. Cherkashina, V.V. Mikhailenko, O.G. Kuznetsov, V.N. Kolesnikov, A.A. Fomenko, F.A. Malysheva, A.A. Uzdenova, R.A. Chemurziev

Long-term outcome of repeat operations in 118 patients with aorto-femoral graft occlusions and recurrent limb critical ischemia were compared corresponding to the variant of distal anastomoses. In early postoperative period limbs were salvaged in total 88.4% of patients, perioperative mortality was 2.5%. Five-year survival after repeat operation was 81.2%. The patency of reconstructed aorto-femoral grafts was the worst in patients with plasty of distal anastomosis without its repositioning: till the fifth year all 100% of grafts were thrombosed, limbs were salvaged in 27.4%. In cases of open reconstruction and distal end-to-side anastomosis repositioning during the first 3 years graft patency was significantly higher, but till the fifth year all grafts were thrombosed, though the rate of limb salvage was 57.3%. The best rate of graft patency was achieved after resection and plasty of distal anastomosis – 73.5% till the fifth year postoperatively; limb salvage rate was 79.6%. Graft patency was little worse after open desobliteration of distal anastomosis region with its consecutive end-to-end repositioning: in 3 years the rate of graft patency began to decrease and comprised 27.2% in 5 years, limb salvage being 77.8%.

KEY WORDS: aorto-femoral graft occlusion, repeat surgery, lower limb critical ischemia.

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