[Reconstruction of isolated lower leg arteriovenous occlusions in the critical foot ischemia stage--assessment of current status]. / Rekonstruktionen bei isolierten Unterschenkelarterienverschlüssen im Stadium der kritischen Fussischämie--eine Bestandsaufnahme.

Between May 1, 1986 and November 1, 1994 94 distal reconstructions were performed in diabetics with isolated tibioperoneal vessel occlusive disease. Mostly the below knee popliteal artery was used as inflow site and most grafts were anastomosed distally to a malleolar artery. Autologous vein was implanted throughout. Mortality at 30 days was 1.06%. Primary and secondary cumulative patency rates were 78% and 82% at 1 year, 65% and 78% at 5 years. Limb salvage rates were 76% at 1 year and 72% at 5 years. Major amputations became inevitable in 12 cases of uncontrollable foot infections despite patent grafts. This is probably due to the diabetic immunopathy. The experience we have gained suggests that distal bypasses in patients with peripheral vascular occlusive disease and critical foot ischemia are excellently suited to attain limb salvage.