Objective: There are limited data on outcomes after lower extremity oncovascular reconstructions. This study aims to share our institutional experience, focusing on patient-reported clinical outcomes, safety, and patency rates for this surgical approach.
Methods: Between April 2013 and October 2022, 32 patients diagnosed with neoplasms featuring invasion of the lower limb vessels underwent surgical tumor resection followed by vascular reconstruction. A retrospective chart review was conducted, and descriptive statistics were used to evaluate patient demographics, operative details, functional limb outcomes, and patency rates.
Results: Thirty-two patients with a median age of 58 years (interquartile range [IQR], 41.2-62.2 years) required vascular reconstruction during oncological resection. A total of 40 vessels (20 arterial, 20 venous) were reconstructed, with 24 requiring circumferential resection (graft interposition or primary reanastomosis) and 16 involving tangential resection (patch angioplasty or direct repair). The most common tumors treated were soft tissue sarcomas (40.6% [n = 13]). The median hospital length of stay was 7 days (IQR, 5-11 days). There were no 30-day deaths. Two venous reconstructions exhibited thrombosis, one on the first postoperative day and another after 5 months. One arterial reconstruction occluded 5 months postoperatively. Three patients required reinterventions to maintain patency. At 1 year, patency rates for arterial and venous reconstructions were 95% (95% CI, 85.9%-100%) and 89.4% (95% CI, 76.5%-100%), respectively. The median follow-up period was 31.5 months (IQR, 14-61 months). Twenty-eight patients reported full lower extremity functionality at their last follow-up, and four required assistance to ambulate; one patient remained bedridden, attributable to chemotherapy-induced sarcopenia.
Conclusions: Vascular reconstruction after oncological resections is associated with high rates of patency and function preservation. Reinterventions, reconstruction occlusion, and infection are rare complications.
Keywords: Oncovascular; Sarcoma; Vascular reconstruction.
Copyright © 2025. Published by Elsevier Inc.