ARTERIALIZATION OF VENOUS BLOOD FLOW OF THE FOOT FOR LIMB SALVAGE FROM AMPUTATION IN PATIENTS SUFFERING FROM THROMBOANGIITIS OBLITERANS WITH OCCLUSION OF THE TIBIAL AND PEDAL ARTERIES IN CRITICAL ISCHEMIA

A.V. Pokrovsky, V.N. Dan, A.V. Chupin
Department of Vascular Surgery, A.V. Vishnevsky Institute of Surgery,
Russian Academy of Medical Sciences,
Moscow, Russia

The present paper is a summary of a twelve-year experience gained by the Department of Vascular Surgery, A.V.Vishnevsky Institute of Surgery, of Medical Sciences, with the treatment of patients suffering from thromboangiitis obliterans with the symptoms of critical ischemia and occlusion of the tibial and pedal arteries. In view of the poor runoff and ineffectiveness of conservative therapy for limb salvage, 56 patients underwent arterialization of venous blood flow of the foot according to the technique elaborated at the Department in 1986. The superficial venous network of the foot was employed for arterialization in 25 patients. The deep venous system of the foot was used in 28 patients, In the short-term postoperative period following arterialization of venous blood flow of the foot, the symptoms of critical ischemia could be removed and the limb saved from amputation in 50 (94.3%) patients. Analysis of the long-term results made after 5 years has shown that the cumulative limb salvage and patency of the arteriovenous bypasses were 88.3% and 45.3%, respectively. Evaluation of the short- and long-term results of arterialization of venous blood flow of the foot in patients suffering from thromboangiitis obliterans with occlusion of the tibial arteries allows to regard it the operation of choice for limb salvage in patients with critical ischemia.

KEY WORDS: thromboangiitis obliterans, critical ischemia.

P. 86

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