Hitchcock, Claude R.; Johnson, Frank E.; Bascom, John U.; Murphy, Thomas O.
February 1959
Angiology;Feb1959, Vol. 10 Issue 1, p11
Academic Journal
Clinical results have been reported on 183 vascular graft and shunt procedures performed during recent years on 178 patients at the University Hospital and the Minneapolis General Hospital. There were 92 femoral-popliteal shunts with 62 successful operations (67.4 per cent success), 7 aorta-iliac shunts with 5 successful operations (71.4 per cent success), 18 iliac-femoral shunts with 12 successful operations (66.6 per cent success), and 25 aorta-femoral shunts with 21 successful operations (84 per cent success). In patients with aorta-iliac and aorta-femoral shunts we have had 95 per cent success with the use of nylon grafts. The results of shunt procedures from the iliac to the femoral artery have been virtually identical between autogenous vein grafts and nylon grafts, with 83.3 per cent success for the autogenous vein cases and 80 per cent success for the nylon cases. Forty patients have been operated upon for Leriche syndrome and in those with nylon reconstitutions we have had an 80 per cent success rate. When Ivalon has been used to reconstitute flow results have been good in 77.7 per cent of patients; with the use of homografts the success rate has been 68.7 per cent. Patients with femoral-popliteal shunts constitute the largest single group in our series with 92 operations performed and an over-all success rate of 67.4 per cent. At this time the best results have been obtained with autogenous venous grafts (84.3 per cent success), and the Edwards-Tapp nylon grafts have been somewhat less successful (53 per cent success). Endarterectomy for specific segmental occlusions in the lower aorta, common iliac arteries and external iliac arteries has been highly successful. We believe this procedure is of considerable benefit in many of the shunt and graft procedures when used to prepare the host arteries for receipt of the graft. Our experience with shunt procedures in diabetic patients has been rather small, but the problem of poor tissue healing and high susceptibility to infection makes surgery in these patients more difficult than in nondiabetics. Considering the advanced age of patients requiring vascular reconstitutive surgery, it is important that we continue our efforts to provide readily available prosthetic materials for grafts and shunts that will not leak copious quantities of blood upon reconstitution of flow. Continued research efforts along this line will be particularly rewarding.


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