Patterns of atherosclerotic occlusive disease of lower leg and pedal arteries in hypertensive patients undergoing infrainguinal bypass procedures

• OBJECTIVE: To analyse the atherosclerotic involvement of lower leg and foot arteries in patients undergoing infrainguinal bypass grafting. SETTING: Department of Surgery, University Hospital. PATIENTS: Among 282 limbs (267 patients), fifty limbs belonged to hypertensive nondiabetics (Group A), 39 to hypertensive diabetics (Group B), 129 to normotensive nondiabetics (Group C) and 64 to normotensive diabetics (Group D). INTERVENTIONS: Femoropopliteal or femorodistal bypass procedures. MEASURES: Intraoperative postreconstruction serial angiography of the lower leg and foot arteries. RESULTS: Occlusion rate of two or three lower leg arteries was significantly higher among diabetics (Group B 77% and Group D 73%, respectively) compared to nondiabetics (Group A 56% and Group D 51%, respectively). It was similar in diabetic patients with or without hypertension. The incidence of having both foot arches (dorsal and plantar arch) intact was significantly higher in nondiabetic patients with hypertension (Group A). Only 5.8% of these patients demonstrated both deficient or occluded foot arches compared to 18% in Group B and 31% in Group C and 20% in Group D. CONCLUSION: Hypertension does not seem to contribute to the extent and severity of lower leg and foot vessel involvement in patients undergoing infrainguinal bypass surgery.

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