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Combined Operative Angiodilation and Arterial Reconstruction for Limb Salvage
Christopher J. Corey, MD;
Harry L. Bush, Jr, MD;
Warren C. Widrich, MD;
Donald C. Nabseth, MD
Arch Surg. 1983;118(11):1289-1292.
Abstract
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• Fifteen high-risk patients with threatened limb loss underwent combined operative iliac angiodilation and infrainguinal vascular reconstruction for iliac and femoropopliteal occlusive disease. The patients were poor candidates for combined surgical inflow and outflow reconstruction because of associated cardiopulmonary disease. The mean systolic pressure gradient across the iliac stenosis was 34 ± 5mm Hg. Iliac artery angiodilation was accomplished intraoperatively and reduced all gradients to zero. Stenoses in the distal portion of the deep femoral artery were endarterectomized in nine patients, and six cross-femoral and six distal popliteal or tibial grafts were constructed. Life-table analysis at 36 months showed iliac patency in 86% of cases and successful distal reconstruction In 76%. Our limb salvage rate of 86% suggests that combined intraoperative angiodilation by the angiographer and arterial reconstruction by the vascular surgeon may provide effective therapy for high-risk patients.
(Arch Surg 1983;118:1289-1292)
Author Affiliations
From the Departments of Surgery (Drs Corey, Bush, and Nabseth) and Radiology (Dr Widrich), Boston Veterans Administration Medical Center and Tufts University School of Medicine, Boston.
Footnotes
Accepted for publication March 3, 1983.
Read before the ninth annual meeting of the New England Society for Vascular Surgery, Bretton Woods, NH, Oct 14, 1982.
Reprint requests to Surgical Service (112), Boston Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA 02130 (Dr Bush).
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