Limb hemodynamics after aortic aneurysm resection

K. C. Bodily, B. L. Thiele and D. E. Strandness Jr

Preoperative ankle/arm indices were determined in 104 lower extremities from 53 patients who underwent prosthetic graft placement for abdominal aortic aneurysms. Sixty-nine percent of the limbs (group 1) had a normal index; 31% of the limbs (group 2) had indices indicative of arterial occlusive disease. Early postoperative ankle/arm indices were determined in 87 limbs (57 in group 1 and 30 in group 2). Twelve group 1 limbs exhibited a postoperative decrease in the index. In group 2, four of the five decreases were seen when the distal anastomosis was placed above the inguinal ligament, while all 17 group 2 limbs in which the index increased had the distal anastomoses performed at the common femoral level. In 1.8% of the group 1 limbs and 6.7% of the group 2 limbs, a subsequent arterial procedure below the inguinal ligament was required. An additional 1.8% of group 1 limbs and 6.7% of group 2 limbs had undergone a distal arterial procedure prior to aneurysm resection.