J Korean Soc Vasc Surg.  2007 May;23(1):27-31.

Lower Extremity Bypasses in Patients with Dialysis-dependent End-stage Renal Disease

• Han SW
• Kim HK
• Choi HH
• Huh S
• Kim YW

Abstract

PURPOSE: The combination of critical limb ischemia and dialysis-dependent end-stage renal disease (DD-ESRD) represents a challenging clinical problem. The present study was undertaken to examine our experience with this combined malady at our hospital and to determine if performing lower extremity bypass in these patients is justified. METHOD: From June 2001 to May 2006, 12 arterial reconstructions were performed in 9 patients (mean age: 64.7+/-6.7 years) suffering with DD-ESRD and diabetes mellitus. The risk factors that were association with surgical morbidity and mortality, limb loss and graft patency were retrospectively reviewed. RESULT: The in-hospital mortality rate was 18.2%. There was no graft occlusion during the follow-up periods. The limb salvage rate was 82.5% at 1 year. There were 2 major limb amputations despite that the bypass grafts were patent. The 1-year and 3-year cumulative survival rates were 63.6% and 33.9%, respectively.
CONCLUSION
After performing lower extremity arterial reconstruction, the limb salvage rates were acceptable in patients with critical ischemia and DD-ESRD, but the survival rates were poor. Failure to salvage the limb in these patients was due to infectious wound problems rather than to graft thrombosis.

Keyword

Chronic renal failure; Dialysis; Bypass; Limb salvage; Survival rate

MeSH Terms

Amputation
Diabetes Mellitus
Dialysis
Extremities
Follow-Up Studies
Hospital Mortality
Humans
Ischemia
Kidney Failure, Chronic*
Limb Salvage
Lower Extremity*
Mortality
Retrospective Studies
Risk Factors
Survival Rate
Thrombosis
Transplants
Wounds and Injuries