대퇴동맥-대퇴동맥 회로 조성술시 예후에 영향을 미치는 요인 = Prediction of Femoro Femoral Bypass Outcome

다국어 초록 (Multilingual Abstract)

There are femorofemoral bypass, iliac endarterectomy, iliofemoral bypass, aortobifemoral bypass, axillofemoral bypass and endovascular surgery for treatment of unilateral iliac disease. Among those procedure, femorofemoral bypass is preferred by surgeons, because it carries low operative morbidity and mortality, short operation time and technically easy to do. It can be done with low mortality in high risk old patients and can be done in patient who has previous vascular surgery. But one of draw back for this procedure is high occlusion rate. The speculated factors for high occlusion are the hemodynamic status of inflow artery, status of distal runoff vessel, technical problem and type of graft material. We have thought that occlusion are caused by poor hemodynamic status of inflow artery and that is why we carried out this study to see if there is any relationship between the hemodynamic status of the inflow artery and outcome of femorofemoral bypass. We had measured the hemodynamic status of the inflow artery by using prediction rate. After measuring minimum diameter and maximum diameter of donor iliac artery on preoperative angiogram, we had calculated prediction rate by divided minimum diameter with maximum diameter and then multiply 100 as percentile. For this study, we had elected 31 femorofemoral bypass which were performed at Korea University Hospital between 1985 to 1992. Among 31 cases, 6 cases were occluded within 5 years postoperatively. The mean prediction patency was 74.7% in graft patent group and 41.1% in graft failure group.(p$lt;0. 05) In 14 cases of over 50% prediction patency group, one case(7.1%) was occluded and 17 below 50% prediction patency group, 5 cass(29.4%) were occluded.
In conclusion, in femorofemoral bypass, prediction patency of inflow iliac artery on preoperative angiogram will be good predictor of graft patency. In unilateral iliac occlusive disease, the group of over 50% prediction patency of inflow iliac artery is compatible, but in the group of below 50% prediction patency is not compatible for femorofemoral bypass.