ARTERIAL RECONSTRUCTION FOR LOWER-LIMB ISCHEMIA IN HONG-KONG CHINESE

Background: Lower limb ischaemia due to peripheral arterial disease is , uncommon in Chinese people, and few arterial bypass operations have been performed. The management of a consecutive series of patients who were admitted to our department with severe lower limb ischaemis betw een March 1990 and October 1996 is reported here. Methods: A total of 91 primary arterial bypass operations were performed for 83 patients ( eight patients had bilateral, or two procedures). Of these, 84 operati ons were for foot salvage and seven operations were for debilitating c laudication. There were 80 infra-inguinal bypasses, 10 of which requir ed additional femoro-femoral crossover grafts to improve in-flow. The remaining 11 bypass procedures were performed for aorto-iliac occlusio n. which included aortobifemoral bypass (5), axillobifemoral bypass (3 ) and cross-femoral bypass (3) grafts. There were 46 male and 37 femal e patients, with a median age of 70 years (36-94). Results: Six patien ts died (6.6%) postoperatively, all of whom were in the foot salvage g roup. The overall cumulative foot salvage rate and graft patency was 8 4 and 56%, respectively, at 5 years. Conclusions: These results justif ied the use Of the same aggressive approach that was adopted in Wester n countries for the treatment of peripheral arterial disease, which se emed to be an emerging problem in Hong Kong.