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Korean J Thorac Cardiovasc Surg 1990; 23(2): 333-341

Published online April 1, 1990

Copyright © Journal of Chest Surgery.

A clinical analysis of atherosclerosis obliterance in the lower extremities

김종만,조규석,박주철,유세영`

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Atherosclerotic obstructive disease has been the major cause of chronic arterial insufficiency in the lower extremity in the western countries. Nowadays. it gains widespread attention in Korea, as its incidence is gradually increasing with so-called westernization of disease pattern. Thirty five patient with atherosclerotic obstructive disease in the lower extremity who were treated with operative intervention at Dept. of Cardiovascular Surgery in Kyung Hee University Hospital between June 1979 and December 1989 were retrospectively analyzed to evaluate clinical pattern and operative outcome. Preoperative main problem for operative indication was disabling claudication in most patients[24 cases], other were rest pain[10 cases] and gangrene and ulceration[8 cases]. The patients were 32 men and 3 women ranging from 25 to 69 years. old. Diabetes Mellitus was associated in 6 patients. The patients were classified into three major groups according to obstructive pattern : Group I^a aortoiliac pattern, Group II; femoropopliteal pattern and Group g; tibioperoneal pattern. A majority of patients belonged to group I [27 cases], 8 patients came under group II .and none in group g. Thirty patients underwent bypass operation with autogenous saphenous vein or synthetic graft with or without concomitant lumbar sympathectomy. Remaining 5 patients were operated on with sympathectomy only, Bypass procedures were anatomic bypass in 22 cases: aortoiliac artery bypass in 11 cases, femoropopliteal artery bypass in 10 cases, sequential femoropopliteal artery bypass in one case and extra-anatomic bypass in 8 cases, axillary-bifemoral artery bypass in one case and femorofemoral artery bypass in 7 cases. Postoperative complications which mainly composed of superficial wound infection[5 cases] which were treated without any significant sequel in all cases and thrombosis[2 cases]. Three patients died whose causes of death were acute renal failure in 2 cases and myocardial infarction in other, The overall patency, rate was 70Zo in 5 years. In conclusion, the clinical pattern and operative outcome were similar to he western pattern and all cases of death did not related to operative procedures and ischemic symptoms were relieved by bypass operations except several cases. I think and recommend that all patients suffering chronic arterial insufficiency by atherosclerosis obliterans ought to be managed with urgent and adequate operative procedure.

Article

Korean J Thorac Cardiovasc Surg 1990; 23(2): 333-341

Published online April 1, 1990

Copyright © Journal of Chest Surgery.

A clinical analysis of atherosclerosis obliterance in the lower extremities

김종만,조규석,박주철,유세영`

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Atherosclerotic obstructive disease has been the major cause of chronic arterial insufficiency in the lower extremity in the western countries. Nowadays. it gains widespread attention in Korea, as its incidence is gradually increasing with so-called westernization of disease pattern. Thirty five patient with atherosclerotic obstructive disease in the lower extremity who were treated with operative intervention at Dept. of Cardiovascular Surgery in Kyung Hee University Hospital between June 1979 and December 1989 were retrospectively analyzed to evaluate clinical pattern and operative outcome. Preoperative main problem for operative indication was disabling claudication in most patients[24 cases], other were rest pain[10 cases] and gangrene and ulceration[8 cases]. The patients were 32 men and 3 women ranging from 25 to 69 years. old. Diabetes Mellitus was associated in 6 patients. The patients were classified into three major groups according to obstructive pattern : Group I^a aortoiliac pattern, Group II; femoropopliteal pattern and Group g; tibioperoneal pattern. A majority of patients belonged to group I [27 cases], 8 patients came under group II .and none in group g. Thirty patients underwent bypass operation with autogenous saphenous vein or synthetic graft with or without concomitant lumbar sympathectomy. Remaining 5 patients were operated on with sympathectomy only, Bypass procedures were anatomic bypass in 22 cases: aortoiliac artery bypass in 11 cases, femoropopliteal artery bypass in 10 cases, sequential femoropopliteal artery bypass in one case and extra-anatomic bypass in 8 cases, axillary-bifemoral artery bypass in one case and femorofemoral artery bypass in 7 cases. Postoperative complications which mainly composed of superficial wound infection[5 cases] which were treated without any significant sequel in all cases and thrombosis[2 cases]. Three patients died whose causes of death were acute renal failure in 2 cases and myocardial infarction in other, The overall patency, rate was 70Zo in 5 years. In conclusion, the clinical pattern and operative outcome were similar to he western pattern and all cases of death did not related to operative procedures and ischemic symptoms were relieved by bypass operations except several cases. I think and recommend that all patients suffering chronic arterial insufficiency by atherosclerosis obliterans ought to be managed with urgent and adequate operative procedure.

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