Femorotibial reconstructions for chronic critical leg ischaemia: influence on outcome by diabetes, gender and age.

Abstract

To analyse the influence of risk factors on the outcome of femorotibial reconstructions for chronic critical leg ischaemia. A longitudinal observational study of patients undergoing femorotibial reconstruction. A regional hospital and an academic referral centre. One hundred and eighty-eight patients undergoing 209 reconstructions to the tibial vessels for chronic critical leg ischaemia, 149 of them with in situ vein grafts. Graft patency, leg salvage and survival rates. Severity of preoperative ischaemia influenced the immediate outcome of reconstruction. Increasing age did not influence graft patency, leg salvage or survival rates. A combination of female sex and diabetes was associated with low graft patency and leg salvage (52% and 42% at 18 months). Diabetes was associated with a decreased survival. With proper patient selection, patency and leg salvage rates in older (> 80 years) patient groups with multiple risk factors justify an active reconstruction policy.