caa a22 4500 475801490 CHVBK 20180406123738.0 cr unu---uuuuu 170329e20000601xx s 000 0 eng 10.1007/s002689910117 doi (NATIONALLICENCE)springer-10.1007/s002689910117 Limits of Infrapopliteal Bypass Surgery for Critical Leg Ischemia: When Not to Reconstruct [Elektronische Daten] [Fausto Biancari, Ilkka Kantonen, Anders Albäck, Sorjo Mätzke, Michael Luther, Mauri Lepäntalo] Abstract.: The aim of this study was to identify the risk factors affecting the immediate 30-day postoperative outcome of infrapopliteal bypass grafts. A series of 511 revascularization procedures to the infrapopliteal arteries have been performed in 439 patients with critical leg ischemia. There were 306 crural bypasses and 205 pedal bypasses. The 30-day postoperative primary and secondary patency rates were 77.5% and 83.4%, respectively; the leg salvage rate was 89.8%; the survival rate was 94.7%; and 85.1% of patients were alive with a salvaged leg. A history of myocardial infarction, angina pectoris, or stroke had a great impact on the postoperative cardiac and cerebrovascular fatal and nonfatal complications. C-reactive protein arose as an important predictor of the length of hospital stay (p= 0.03), postoperative cardiac complications (p= 0.02), leg salvage (p= 0.009), amputation with patent graft (p= 0.009), and patients who survived with a salvaged leg (p= 0.006). Poor results were achieved in patients on long-term dialysis. Surgical experience had an influence on leg salvage (p= 0.02) and on patients alive with salvaged leg rates (p= 0.009). Infrapopliteal bypass surgery is a demanding procedure requiring high surgical skill and experience. Revascularization may be contraindicated when severe coronary disease, previous stroke, renal failure requiring long-term dialysis, diabetes, or high serum concentration of C-reactive protein coexist with critical leg ischemia, as these patients are at high risk for early postoperative leg or life loss. 2000 by the Société Internationale de Chir, 2000 Biancari Fausto Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut Kantonen Ilkka Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut Albäck Anders Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut Mätzke Sorjo Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut Luther Michael Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut Lepäntalo Mauri Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut World Journal of Surgery Springer-Verlag 24/6(2000-06-01), 727-733 0364-2313 24:6<727 2000 24 268 https://doi.org/10.1007/s002689910117 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689910117 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Biancari Fausto Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Kantonen Ilkka Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Albäck Anders Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Mätzke Sorjo Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Luther Michael Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut NATIONALLICENCE 700 1- Lepäntalo Mauri Division of Vascular Surgery, Helsinki University Central Hospital, PO Box 340, 00029 HYKS, Helsinki, Finland, Finland aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/6(2000-06-01), 727-733 0364-2313 24:6<727 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer