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Popliteal Angioplasty as an Adjunct to Above-the-Knee Synthetic Femoropopliteal Bypass: Comparison of Long-Term Results with Below-the-Knee Bypass

Department of Surgery II, Kyushu University, Fukuoka, Japan

Thomas E. Arnold, MD

Department of Surgery, Division of Vascular Surgery, Health Sciences Center University at Stony Brook, Stony Brook, New York

Takafumi Maekawa, MD, PhD

Department of Surgery II, Kyushu University, Fukuoka, Japan

Teruo Matsumoto, MD, PhD

Department of Surgery, Division of Vascular Surgery, Health Sciences Center University at Stony Brook, Stony Brook, New York

Morris D. Kerstein, MD

Department of Surgery, Allegheny University Hospitals/Allegheny University of the Health Sciences, Medical College of Pennsylvania/Hahnemann University, Philadelphia, Pennsylvania

Long-term results of 27 above-the-knee (AK) synthetic femoropopliteal (SYN-FP) bypasses with simultaneous intraoperative popliteal angioplasty (Group A) were reviewed and compared with 23 below-the-knee (BK) SYN-FP bypasses performed during the same time interval (Group B). Twenty-six of the 27 (96%) popliteal arteries were angioplastied successfully. One patient died postoperatively. Twenty-five limbs had no early occlusions (<30 days), and the postoperative ankle:brachial ratio increased from 0.40 to 0.81 (p < 0.01). The one-year primary patency, secondary patency, and limb salvage rates were 69%, 82%, and 95% in Group A, and 66%, 66%, and 81% in Group B, respectively (p < 0.05). Intraoperative popliteal angioplasty as an adjunct to femoropopliteal bypass was effective. Five-year primary patency, secondary patency, and limb-salvage rates for Group A were 51%, 58%, and 76%, and 34%, 46%, and 59% for Group B, respectively. The mortality rate at five years was 59% (16/27) for Group A and 65% (15/23) for Group B.

Vascular and Endovascular Surgery, Vol. 33, No. 2, 151-155 (1999)
DOI: 10.1177/153857449903300207


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