Sequential femoral-tibial bypass for severe limb ischemia.

摘要: Sequential femoral-popliteal-tibial bypass has been recommended for surgical treatment of severe lower limb ischemia in patients with complex multisegmental arterial occlusion. To evaluate this alternative technique critically, sequential grafting was performed 40 limbs manifest by rest pain (20), nonhealing ulceration (eight), or gangrene (12). Measurement segmental Doppler pressure revealed a significant increase ankle brachial index from 0.29 +/- 0.15 before operation to 0.93 0.12 after operation, confirming the hemodynamic improvement among these patients. In early postoperative period occlusion distal graft segment recognized 12 characteristic reduction ankle/brachial (0.50 0.14), while low thigh pressures remained unchanged. Recurrent prevented most persistent patency proximal segment. Overall, achieved 29 38 limbs, salvage rate (76%) comparable that reported femoral-distal femoral-popliteal an isolated popliteal Early failure series resulted major amputation eight 16 significantly than other techniques. is useful method salvage. The preservation may be important type reconstruction.