Indications for distal arterial reconstruction in the presence of palpable pedal pulses

Steven P. Rivers, Larry A. Scher, Frank J. Veith

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Eight patients with severe pedal ischemia in the presence of palpable foot pulses are described. All had atherosclerosis, and seven patients also had diabetes. There were two anatomic patterns of disease, including supramalleolar obstruction with reconstitution of pulsatile flow in three patients and segmental occlusion of the pedal vessels in five. All patients underwent arterial reconstructive surgery. Patency was sustained in six patients, with limb salvage in five and below-knee amputation in one patient for persistent necrosis and infection of an open amputation. Of the two eventual bypass failures, a transmetatarsal amputation continued to heal in one patient, and the other required amputation below the knee. Palpable pedal pulses and satisfactory ankle/brachial indexes did not rule out the presence of surgically correctable distal arterial occlusive disease. Therefore arteriography is indicated in any patient with persistent forefoot ischemia that fails to respond to conservative measures. The safety and patency of the distal reconstructive procedures performed in this series suggest that salvage of weight-bearing tissue and rapid healing, as well as limb salvage, are legitimate indications for revascularization.

Original languageEnglish (US)
Pages (from-to)552-557
Number of pages6
JournalJournal of Vascular Surgery
Volume12
Issue number5
DOIs
StatePublished - 1990

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Foot
Amputation
Limb Salvage
Knee
Reconstructive Surgical Procedures
Ischemia
Ankle Brachial Index
Pulsatile Flow
Arterial Occlusive Diseases
Weight-Bearing
Atherosclerosis
Angiography
Necrosis
Safety
Infection

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Indications for distal arterial reconstruction in the presence of palpable pedal pulses. / Rivers, Steven P.; Scher, Larry A.; Veith, Frank J.

In: Journal of Vascular Surgery, Vol. 12, No. 5, 1990, p. 552-557.

Research output: Contribution to journalArticle

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