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Article
July 7, 1956

ANALYSIS OF ONE HUNDRED TWENTY CONSECUTIVE CASES OF MAJOR ARTERIAL GRAFTS

JAMA. 1956;161(10):953-956. doi:10.1001/jama.1956.02970100019006
Abstract

• Freeze-dried sections of artery were used as homografts in 77 cases of aortoiliac and 43 cases of femoral obstruction. The preoperative angiograms were then restudied in order to find out which features had the greatest value in predicting the success or failure of the grafting operation. The age of the patient, presence or absence of diabetes, and presence or absence of heart disease had little predictive value. Most important was the question of whether the outflow from the distal part of the graft would equal the inflow. When it did not, thrombosis frequently occurred.

Among 103 cases with favorable angiographic findings, the results were good in 99; among 11 with unfavorable findings, the results were good in 3. There was also an indeterminate group of six cases in which one good result was obtained Case histories are given to show the varied difficulties and complications encountered. Twelve patients died. In the others, symptomatic improvement sometimes occurred even if the graft became occluded, and in no case was amputation necessary. In the successful cases, pulsation reappeared distal to the graft and claudication pain was relieved.

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