Results of arterial reconstruction of the foot
D. Buchbinder, A. R. Pasch, D. L. Rollins, B. C. Dillon, D. J. Douglas, J. J. Schuler and D. P. Flanigan
Sixty-five patients with critical ischemia required bypass to foot vessels.
These procedures were performed by five different techniques: (1)
femoral-foot bypass with in situ saphenous vein; (2) femoral-foot bypass
with reversed autogenous saphenous vein; (3) femoral-foot bypass with
polytetrafluoroethylene (PTFE); (4) popliteal-foot bypass with reversed
autogenous saphenous vein; and (5) popliteal-foot bypass with PTFE. The
two-year patency rate of femoral-foot bypass with in situ vein (96%) was
significantly higher than femoral-foot bypass with reversed vein (42%),
while both procedures demonstrated significantly higher patency than
femoral-foot bypass with PTFE (0%). Popliteal-foot bypass with reversed
vein (92%) was superior to both popliteal-foot bypass with PTFE (27%) and
femoral-foot bypass with PTFE (0%). Femoral-foot bypass with in situ vein
and popliteal-foot bypass with reversed vein have appreciably increased
vein utilization, graft patency, and limb salvage.
