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November 1971

Surgery for Femoropopliteal Atherosclerosis: A Reappraisal

Author Affiliations

San Francisco
From the Department of Surgery, University of California, San Francisco.; Dr. James is now with the United States Naval Hospital, San Diego, Calif.

Arch Surg. 1971;103(5):548-553. doi:10.1001/archsurg.1971.01350110046007

The reversed saphenous vein graft, used as a bypass for 80 patients with occlusive disease and 19 patients with popliteal aneurysms, showed continued long-term patency in 80% (44) of patients without preoperative outflow obstruction but in less than 50% (17) of patients with significant outflow lesions. Endarterectomy was a less durable procedure in a comparable series. Analysis of the ultimate clinical outcome, taking into account morbidity from graft closure or advancing atherosclerosis and mortality from other cardiovascular disease indicates a satisfactory three-year result in 70% (23) of patients with mild claudication from femoral occlusion who had additional lesions. Only 26% (seven) of patients who had undergone "leg salvage" operations for intractable pain or early gangrene were alive with a functioning pain-free extremity one year after operation.

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