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September 1983

Femoropopliteal Graft FailuresClinical Consequences and Success of Secondary Reconstructions

Author Affiliations

From the General Surgical Services, Massachusetts General Hospital, and Department of Surgery, Harvard Medical School, Boston.

Arch Surg. 1983;118(9):1043-1047. doi:10.1001/archsurg.1983.01390090033007

• We examined 188 failed femoropopliteal grafts during a 16-year period to evaluate the clinical consequences of graft failure and success of secondary revascularization procedures. In limbs with grafts placed for claudication, conditions of 9% with failed grafts remained improved despite graft occlusion, 67% returned to preoperative status, and 24% showed worsened ischemia. One third of claudicants with failed grafts underwent secondary procedures. Ultimately, only 7% of failed grafts in claudicants resulted in amputation, and overall risk of limb loss in patients undergoing operation for claudication alone was low (2%). After failure of grafts performed for limb-salvage indications, 21% of limbs were still improved, and 79% reverted to limb-threatened status, more than half of the limbs undergoing subsequent reoperation. Overall, secondary attempts at reconstruction appeared justified. Although the five-year patency rate of such grafts was only 31%, limb salvage was achieved in 52%, with relatively low morbidity and mortality.

(Arch Surg 1983;118:1043-1047)