Distal tibial vein grafts for limb salvage.
Bypasses below the tibial peroneal trunk, which are not commonly performed, are an effective method of limb salvage. We have done long-term follow-up of all 148 consecutive grafts done during the past 19 years. By careful patient selection, detailed arteriograms, utilization of veins from all extremities, meticulous operating technique, and noninvasive follow-up, we have achieved a limb salvage rate of 75% and a cumulative five-year patency rate of 62%. Diabetics made up 53% of the series and did not affect the results. Seventy-one percent of all failures occurred in the first six months. Considering the charges for hospitalization, amputation, prostheses, and rehabilitation, distal tibial bypass procedures are cost-effective.
D000368:Aged; D003365:Costs and Cost Analysis; D005260:Female; D005734:Gangrene / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D013977:Tibia / Q000098:blood supply*; D014680:Veins / Q000637:transplantation*