Outcome of Lower Limb Distal Bypass in Afro-Caribbean Populations
Departments of Vascular Surgery, Kings College Hospital, Denmark Hill, London, UK.Vascular and Endovascular Surgery (Impact Factor: 0.66). 05/2011; 45(6):514-8. DOI: 10.1177/1538574411408350
There is little data on outcome following lower limb bypass surgery in ethnic minorities in the United Kingdom. We looked at the results of distal bypass surgery in Afro-Caribbeans (AFCs) and compared it to caucasians (CAs). Patients undergoing distal bypass between 2004 and 2009 were analyzed. Life table analyses and log rank were used to compare graft patency and amputation-free survival. A total of 86 CA and 39 AFC patients, with a median age of 78 years and 73 years, respectively (P = .01), underwent bypass. There were more women in AFC groups (41.1%) compared to CA group (19.2%, P = .01). Tissue loss as indication for surgery was more in AFC than in CA group (92.3% vs73.9%, P = .03). Primary, primary-assisted and secondary patency rates, and amputation-free survival at 12 months for AFCs compared to CAs (51.3 vs 44.6; 85.2 vs 80.9; 91.2 vs 84.4; and 84.9 vs 75.1). Graft patency after lower limb distal revascularization in AFCs is comparable to CAs.
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ABSTRACT: Revascularization of the lower extremity in patients with diabetes or chronic obstructive arterial disease is a challenging, still unsolved problem. Modern day technique (stem cell therapy, hyperbaric therapy) has yet to deliver satisfactory results. Homogenous (safenous vein) or heterogeneous (terom, dacron, PTFE-teflon) by-pass surgery is limited because of technical difficulty and positive outcomes have a short duration. All these lead to, in most patients, to amputations as first line therapy or as an alternative to failed approaches. By-pass surgery is limited by graft obstruction. One of the current approaches is the use of omental flap autotransplantation.Chirurgia (Bucharest, Romania: 1990) 09/2011; 106(5):627-30. · 0.78 Impact Factor
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