Experience with 350 crural arterial reconstructions: analysis and conclusions.
Distal arterial reconstructions differ from those in the pelvic and femoral region in the following 3 characteristics: wound healing is endangered by ischemic tissue: vessel diameters are very small; poor outflow conditions can reduce blood flow velocity in the long femoro-crural grafts thus increasing the risk of reocclusion. On the basis of clinical and angiographic follow-up studies we investigated retrospectively various factors influencing the long-term results: bypass material; poor outflow; technique of distal insertion; location of the bypass graft.


CONCLUSIONS
autologous vein provides the best, umbilical vein the second best atrial substitute. Prosthetic material is less satisfactory. AV-fistulae can be successfully employed to reduce peripheral outflow resistance; short bypass lengths can be achieved by proximal end-to-side and distal end-to-end anastomoses; orthotopic location of the bypass yields the best long-term results.
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Largiadèr
D000368:Aged; D000792:Angiography; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D004691:Endarterectomy; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011150:Popliteal Artery / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013562:Sympathectomy; D014680:Veins / Q000637:transplantation
D011138:Polytetrafluoroethylene