NEW APPROACHES TO LIMB SALVAGE BY EXTENDED EXTRA-ANATOMIC BYPASSES AND PROSTHETIC RECONSTRUCTIONS TO FOOT ARTERIES

  • 1 January 1978
    • journal article
    • research article
    • Vol. 84  (6) , 764-774
Abstract
Because femoropopliteal reconstructions with expanded polytetrafluoroethylene (PTFE) and saphenous vein have had comparable patency rates up to 22 mo., this prosthesis was used for longer, more complex bypasses for limb salvage. Axillopopliteal or cross-over axillopopliteal bypasses (14) were performed largely because groin infection or deep femoral artery disease precluded standard procedures; 12 were patent up to 14 mo. Five patients required a bypass from 1 femoral artery to an opposite leg artery; 4 of these were patent up to 17 mo. Because of progressive necrosis, 8 patients required a secondary extension from a femoropopliteal bypass to a distal artery; 5 are patent up to 12 mo. Three patients required extra-anatomic bypass for leg or popliteal space infections; all achieved limb salvage up to 12 mo. Twenty patients without other suitable proximal arteries required a bypass to the dorsalis pedis or anterior tibial artery at the ankle; 10 were patent up to 14 mo. Eleven patients required posterior tibial bypass at or below the ankle; 7 were patent up to 18 mo. One postoperative death followed these 61 procedures. Operations with long PTFE grafts that cross multiple joints can probably salvage limbs for long periods of time with low risk.

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