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September 1983

Femoropopliteal Graft Failures: Clinical 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)