title: Distal bypass to a critically ischemic foot increases the skin perfusion pressure at the opposite site of the distal anastomosis.
abstract: BACKGROUND
  The purpose of the study was to reveal the effect of blood flow supply to the foot by analyzing the skin perfusion pressure values and the pedal arch connection after bypass surgery.
  
  
  METHODS
  We selected 48 operated limbs whose skin perfusion pressure was measured pre- and post-operatively on the opposite site of distal anastomosis. We also assigned the ischemic limbs to three groups according to the patency of the pedal arch: good, intermediate, and poor.
  
  
  RESULTS
  The mean value of skin perfusion pressure increased significantly from 27.0 ± 14.9 to 52.8 ± 16.0 (p < 0.001) post-operatively. Skin perfusion pressure improved in most of the limbs post-operatively and decreased or unchanged in only four limbs, all of which showed improved tissue loss. Three amputated limbs were due to infection, and all showed an increase in skin perfusion pressure.
  
  
  CONCLUSIONS
  It was difficult to correlate limb prognosis to skin perfusion pressure and the pedal arch connection.
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Mochizuki
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan traruba@gmail.com.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hoshina
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shigematsu
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyata
authors.affiliation: Department of Vascular Surgery, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000714:Anastomosis, Surgical; D000792:Angiography; D016638:Critical Illness; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects / Q000379:methods*; D014654:Vascular Patency
keywords: Critical limb ischemia; distal bypass; pedal arch connection; skin perfusion pressure