Infrapopliteal and distal bypass for limb salvage - abstract

ABSTRACT

Because the majority of our patients with lower limb ischemia present with femora popliteal disease, bypass surgery must be done to tibial and distal vessels for limb salvage. In 71 such bypasses done on 66 patients the indications were gangrene, 41, non healing ulcer 12, rest pain 18. Sixty-six bypasses were in situ saphenous vein while five were reversed vein grafts. Fourteen bypasses were done to the ankle or distally (5 dorsalis pedis, 7 posterior tibial, 2 plantar) while 57 were carried to infrapopliteal leg vessels (35 peroneal, 14 posterior tibial, 6 anterior tibial, 3 tibio-peroneal trunk). In the ankle/distal group 1 bypass occluded and 1 limb was lost. In the tibial group 8 bypasses occluded and 7 limbs were amputated. Although bypasses to the tibial and foot vessels are technically more demanding, they do carry a good limb salvage rate and patients should be given the benefit of this treatment (AU)