title: [Distal femoral bypass under local anaesthesia].
abstract: BACKGROUND
  The aim of this article is to present our experience in performing distal femoral bypass under local anaesthesia for high risk patients.
  
  
  METHODS
  Lower limb revascularisation surgery under local anaesthesia was performed on 8 patients in our centre between January and May 2010. The common characteristics of the patients were, advanced age, chronic ischaemic heart disease on antiplatelet treatment, and chronic obstructive pulmonary disease (COPD).
  
  
  RESULTS
  All 8 patients (100%) tolerated the procedure well without having to resort to sedation or invasive anaesthetic procedures. The receiving artery was the posterior tibial in 6 cases (75%) and the popliteal and peroneal in 1 (12%). Early patency of the graft was achieved 7 patients and 1 had early thrombosis with a supracondylar amputation. The technique used was femoral-popliteal in 1 case, femoral-posterior tibial in 6 cases, and popliteal-peroneal in 1 case. The saphenous vein was the graft used, inverted in 1 patient (12%), and in situ in 7 (88%) with a 3mm BARD™ valvotomy. There were no post-operative complications as regards haemorrhage, infections or death. A minor amputation was performed on 3 patients (37%), and after a mean of 3 months (1-4 months) follow-up, 7 cases were free of major amputation.
  
  
  CONCLUSIONS
  Revascularisation of the distal zone of the lower limbs can be safely and effectively performed using local anaesthesia, avoiding the risks of general anaesthesia and without the need to stop antiplatelet treatment. Anatomical problems (obesity) may limit the procedure.
authors.affiliation: Servicio de Cirugía Cardiovascular, Hospital Universitario Virgen de la Arrixaca, Murcia, España. rubentaboadamartin@hotmail.com
authors.forename: Rubén
authors.initials: R
authors.lastname: Taboada Martín
authors.forename: Víctor
authors.initials: V
authors.lastname: Glenn-Ray López
authors.forename: Francisco
authors.initials: F
authors.lastname: Gutiérrez García
authors.forename: Norberto
authors.initials: N
authors.lastname: Cassinello Martínez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation*; D014656:Vascular Surgical Procedures / Q000379:methods