Distal bypass graft for limb salvage.
The use of "distal bypass grafts" in the lower extremity for limb salvage is controversial among vascular surgeons. Twenty-nine "distal grafts", defined as grafts with their distal anastomosis within 3 inches (7.5 cm) of the ankle malleoli, were performed. All patients selected for the procedure had an intact pedal arch in continuity with the grafted vessel and limited gangrene of the foot. The grafts consisted of 4 patients with grafts to the peroneal artery, 3 to the anterior tibial artery, 5 to the dorsalis pedis artery and 17 to the posterior tibial artery. Of the 29 grafts attempted, 22 (76%) continued to function from 6 months to 4 1/2 years postoperatively. The 22 successful grafts consisted of autogenous vein greater than 4 mm in diameter. Twenty-two limbs were salvaged by distal bypass more than 24 hours postoperatively were important prognostic indications. Careful attention to technique and the use of magnification were believed to be important aspects of successful graft construction.
D000368:Aged; D000671:Amputation, Surgical; D000842:Ankle / Q000098:blood supply; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D012501:Saphenous Vein / Q000637:transplantation; D014680:Veins / Q000637:transplantation*