Document Detail

Saphenous vein bypass to pedal arteries. An aggressive strategy for foot salvage.
MedLine Citation:
PMID:  2802989     Owner:  NLM     Status:  MEDLINE    
Patients with forefoot ischemia and severe tibial artery disease present a major challenge to revascularization and foot preservation. Encouraged by the success of saphenous vein bypass to the more proximal arteries of the lower leg, we extended this technique to the pedal arteries. Between February 1986 and September 1988, we performed 26 bypasses in 24 men (mean age, 66 years) with critical foot ischemia. Sixty-three percent of the patients had diabetes mellitus, 50% had hypertension, and 71% were actively smoking. Angiography invariably revealed multiple tibial artery occlusions with reconstitution of the pedal arteries. The foot salvage rate was 83% (mean survival, 14 months), primary patency was 83% (mean survival, 9 months), and survival was 86% (mean, 12 months). There were 11 wound complications (42%); two resulted in disruptions of the distal anastomosis and eventual graft failure. Bypass to the pedal arteries yields a high rate of foot salvage and is comparable with more proximal bypass procedures; however, wound complications are common and require special technical considerations.
H W Harris; J H Rapp; L M Reilly; P A Orlando; W C Krupski; J Goldstone
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  124     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1989-11-09     Completed Date:  1989-11-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1232-5; discussion 1235-6     Citation Subset:  AIM; IM    
Surgical Service, Veterans Administration Medical Center, San Francisco.
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MeSH Terms
Aged, 80 and over
Anastomosis, Surgical
Arteries / surgery*
Blood Flow Velocity
Foot / blood supply
Ischemia / surgery*
Leg / blood supply*
Middle Aged
Postoperative Complications
Saphenous Vein / transplantation*
Grant Support
1 F32 HL07737-01A1/HL/NHLBI NIH HHS

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