When does limb blood flow increase after aortoiliac bypass grafting?
P. M. Walker and K. W. Johnston
We have measured changes that occur in resting and hyperemic calf muscle
blood flow throughout the operative course of nine patients undergoing
aortoiliac grafting for peripheral arterial occlusive disease. There were
four patients with combined aortoiliac and femoropopliteal disease, and
five patients with isolated aortoiliac disease. In all patients, reactive
hyperemia was absent when the aortic cross clamp was removed.
Postoperatively, calf muscle blood flow did not increase substantially for
24 hours regardless of the presence or absence of coexisting
femoropopliteal occlusive disease. Knowing that calf muscle blood flow does
not increase immediately postoperatively may explain why pulses may not be
palpable immediately and why the limb may remain cool for several hours.
Also, this reaffirms that it is best to delay any decision on distal
femoropopliteal repair until the outcome of the proximal reconstruction can
be assessed.
