Document Detail

Distal venous arterialization for lower limb salvage: angiographic appearances and interventional procedures.
MedLine Citation:
PMID:  11553829     Owner:  NLM     Status:  MEDLINE    
Approximately 14%-20% of patients with critical lower limb ischemia are unsuited for distal arterial reconstruction and face major distal amputation. Distal venous arterialization is a unique procedure in which the venous bed is used as an alternative conduit for perfusion of peripheral tissues. Eighteen patients with stage IV Fontaine critical lower limb ischemia underwent venous arterialization. Preoperative angiographic findings confirmed the absence of any below-knee continuous arterial vessels. The most distal satisfactory artery was used for proximal bypass anastomosis, and venous valves were destroyed with Parsonnet probes, cutting balloons, Fogarty catheters, and valvulotomes under radiologic guidance. All patients underwent intra- and postoperative angiography of the venous grafts and the distal venous bed. Primary and secondary graft patencies were 66% and 72%, respectively, at a mean follow-up of 25 months. The limb salvage rate was 83% overall and 75% at 2-year follow-up. Vascular imaging is essential in selecting and following up patients and in determining the appropriate intraoperative procedure.
C Engelke; R A Morgan; J W Quarmby; R S Taylor; A M Belli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiographics : a review publication of the Radiological Society of North America, Inc     Volume:  21     ISSN:  0271-5333     ISO Abbreviation:  Radiographics     Publication Date:    2001 Sep-Oct
Date Detail:
Created Date:  2001-09-12     Completed Date:  2001-10-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8302501     Medline TA:  Radiographics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1239-48; discussion 1248-50     Citation Subset:  IM    
Department of Radiology, St George's Hospital, Blackshaw Rd, London SW17 0QT, England.
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MeSH Terms
Arteriovenous Shunt, Surgical
Blood Vessel Prosthesis Implantation
Follow-Up Studies
Foot / blood supply
Intraoperative Care
Ischemia / radiography*,  surgery*
Leg / blood supply*
Preoperative Care
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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