THE OUTCOME OF RECONSTRUCTIVE SURGERY FOR MULTI-LEVEL OCCLUSIVE ARTERIAL DISEASE OF THE LOWER LIMBS

Abstract

A common dilemma in patients with multi-level disease is whether proximal re-vascularization alone will suffice. Although it is generally accepted that around 75% of these patients will be improved by a properly performed aortic and/or iliac procedure, many series have documented that around 25% of patients with multi-level disease will fail to have sufficient relief of ischaemic symptoms and may require later infra­ inguinal procedure.

If such patients could be identified before surgery, it would often be logical and beneficial to perform simultaneous inflow I outflow re-vascularization or at least to plan for sequential correction within a reasonable time schedule.

Accurate prediction remams elusive. However, the outcome studies may catch the thread by spotting light on the best surgical plan with least morbidity and mortality. So, the outcome studies may clarify the proper indications for various plans of treatment. Nevertheless, the outcome studies may also