A New Method of Angiographic Runoff Evaluation in Femorodistal Reconstructions

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Abstract
• In 62 patients undergoing femorodistal bypass surgery, the foot vessel runoff was analyzed with a new grading system based on intraoperative postreconstruction serial angiography. The patients were divided into two groups according to the level of the distal anastomosis (proximal or low). Good runoff was defined as integrity of the anterior and/or posterior foot arch in proximal femorodistal grafts and integrity of both arches in low bypasses. In the proximal group, runoff was classified as poor when the arches were deficient or occluded, and in the low group, when only one arch was intact. The patency rate after 6 months was 81% in the good runoff group, whereas all grafts in patients with poor runoff were occluded. The new method allowed better prediction of the early outcome than does the primary and secondary pedal arch integrity concept. (Arch Surg. 1990;125:1055-1058)