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Preoperative Angiographic Criteria for Predicting Free-Flap Transfer Outcomes in Patients With Lower-Extremity Peripheral Arterial Disease
- Source :
- The International Journal of Lower Extremity Wounds. 15:325-331
- Publication Year :
- 2016
- Publisher :
- SAGE Publications, 2016.
-
Abstract
- Patients scheduled for microsurgical reconstruction of the lower leg often receive preoperative assessment of recipient vessels using angiography. However, no clear standard is available for evaluating angiographic results to predict free-flap survival outcomes. We developed angiographic criteria for predicting surgical outcome in patients with lower-extremity peripheral arterial disease based on abnormality of the anterior tibial and posterior tibial arteries. We applied the criteria to a small number of patients scheduled for microsurgical reconstruction of the lower leg. Angiographies with arterial abnormalities were classified into 3 groups: favorable free-flap survival, compromised free-flap survival, and postsurgical pedal ischemia. The study enrolled 50 patients between 2005 and 2013. In 42% of patients, arterial abnormalities were observed by angiography. Age >65 years was the strongest risk factor for development of lower-leg arterial abnormality ( P < .001). The anterior tibial and peroneal arteries were significantly more stenotic than other vessels. In the favorable free-flap survival and compromised free-flap survival groups, free-flap transfers were attempted in 7 patients but intraoperatively abandoned in 2 patients, with postoperative failure in 1 patient. In the postsurgical pedal ischemia group, free-flap transfers were attempted in 10 patients but intraoperatively abandoned in 6 patients, with postoperative failure in 3.
- Subjects :
- Male
medicine.medical_specialty
Arterial disease
Ischemia
Free flap
030204 cardiovascular system & hematology
030230 surgery
Free Tissue Flaps
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
medicine
Humans
In patient
Risk factor
Aged
Leg
medicine.diagnostic_test
business.industry
Angiography
General Medicine
Middle Aged
Plastic Surgery Procedures
medicine.disease
Peripheral
Surgery
Tibial Arteries
Female
Radiology
Abnormality
business
Leg Injuries
Subjects
Details
- ISSN :
- 15526941 and 15347346
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- The International Journal of Lower Extremity Wounds
- Accession number :
- edsair.doi.dedup.....b3d936808bd77a3d45d6f7dc28f60424