Small vessel reconstructive surgery of the lower extremities

H. Dardik, I. I. Dardik, Seymour Sprayregen, I. M. Ibrahim, F. Veith

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

On the basis of the experience with small vessel bypass in 30 patients the authors conclude the following. Small vessel bypass should be limited to cases where limb loss is likely and where a functional recovery may be anticipated. It is generally contraindicated if tissue necrosis and infection extends into the proximal foot. If the necrotizing infection is localized, open drainage, debridement, or amputation should be performed with small vessel bypass. Preoperative angiography is critical in determining the location of a suitable small vessel and the quality of the run off. Intraoperative angiography is required to delineate correctable intraoperative defects. Additionally, failure to demonstrate run off or a pedal arch can help support a decision not to re explore a graft should early closure occur. The lateral approach with fibulectomy provides excellent access to the anterior tibial artery and the peroneal artery. The peroneal artery can be employed for small vessel bypass with good results. Although we have emphasized the great number of complications associated with small vessel bypass, an aggressive attitude must be assumed. Selected cases of failed small vessel bypass may be salvaged by thrombectomy with or without graft revision. Finally, small vessel bypass is a major therapeutic advance in vascular surgery. However, the risks indigenous to this operation require optimal patient selection and exquisite operative technique.

Original languageEnglish (US)
Pages (from-to)683-688
Number of pages6
JournalAngiology
Volume26
Issue number9
StatePublished - 1975

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Reconstructive Surgical Procedures
Foot
Lower Extremity
Angiography
Arteries
Tibial Arteries
Transplants
Thrombectomy
Debridement
Infection
Amputation
Patient Selection
Blood Vessels
Drainage
Necrosis
Extremities
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Dardik, H., Dardik, I. I., Sprayregen, S., Ibrahim, I. M., & Veith, F. (1975). Small vessel reconstructive surgery of the lower extremities. Angiology, 26(9), 683-688.

Small vessel reconstructive surgery of the lower extremities. / Dardik, H.; Dardik, I. I.; Sprayregen, Seymour; Ibrahim, I. M.; Veith, F.

In: Angiology, Vol. 26, No. 9, 1975, p. 683-688.

Research output: Contribution to journalArticle

Dardik, H, Dardik, II, Sprayregen, S, Ibrahim, IM & Veith, F 1975, 'Small vessel reconstructive surgery of the lower extremities', Angiology, vol. 26, no. 9, pp. 683-688.
Dardik H, Dardik II, Sprayregen S, Ibrahim IM, Veith F. Small vessel reconstructive surgery of the lower extremities. Angiology. 1975;26(9):683-688.
Dardik, H. ; Dardik, I. I. ; Sprayregen, Seymour ; Ibrahim, I. M. ; Veith, F. / Small vessel reconstructive surgery of the lower extremities. In: Angiology. 1975 ; Vol. 26, No. 9. pp. 683-688.
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