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James J. Schuler, MD; D. Preston Flanigan, MD; Larry R. Williams, MD; Timothy J. Ryan, MD; John J. Castronuovo, MD

Arch Surg. 1983;118(4):472-476.

Abstract
• In an attempt to improve graft patency and limb salvage in patients with isolated tibial vessel and/or popliteal-tibial vessel occlusive disease, bypass grafts from the popliteal or distal superficial femoral artery to infrapopliteal arteries were used in patients requiring bypass for limb salvage. During a 2-year period, 23 patients with patent axial vessels and hemodynamically normal inflow to the level of the knee underwent such bypasses. Cumulative graft patency and limb salvage rates at 31 months were 84% and 70%, respectively. Five of the six patients who required below-knee amputation did so because of progressive gangrene in the presence of a patent bypass. Short bypasses between the popliteal and infrapopliteal arteries can significantly contribute to limb salvage in patients with tibial vessel occlusive disease and may be particularly useful in patients with saphenous veins too short for longer bypasses.

(Arch Surg 1983;118:472-476)

Author Affiliations
From the Peripheral Vascular Surgery Service, Department of Surgery, Veterans Administration West Side Medical Center, Chicago.

Footnotes
Accepted for publication Oct 13, 1982.

Read before the Sixth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Atlanta, May 15, 1982.

Reprint requests to Division of Vascular Surgery, Department of Surgery, University of Illinois at the Medical Center, PO Box 6998, Chicago, IL 60680 (Dr Flanigan).

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