Distal Crural and Pedal Arterial Bypass Limb Saving Revascularisation Surgeries
| Authors | |
|---|---|
| Year of publication | 2002 |
| Type | Article in Periodical |
| Magazine / Source | Cardivoascular Surgery |
| MU Faculty or unit | |
| Citation | |
| Field | Surgery incl. transplantology |
| Keywords | Distal Crural and Pedal Arterial Bypass |
| Description | The diabetic foot syndrome results in critical ischemia and gangrene in its final phase. Revascularisation attempts are often the only chance of saving the limb. The authors present case records of three patients with wet gangrene of the foot in whom amputation of the limb was considered owing to adverse angiographic finding and because all possibilities of conservative therapy have been exhausted. A revision of distal segments of crural and pedal arteries and the subsequent bypass implants reversed the previous adverse development. In all three patients, the defects have healed in relatively short time and their limbs were saved. After having described the three above-mentioned clinical cases (picture documentation of the foot defects, angiography before and after the surgery), the authors open the discussion of the prospects of vascular surgery in the dealing with the most serious phases of the diabetic leg syndrome. Angiography often does not provide information on the situation in the distant periphery of limb arteries owing to the fact that the contrast medium cannot penetrate there through the stenotic and obliterated arterial sections or because of the summation with the bone shadow opacity. Even in cases of adverse angiographic findings, the authors recommend a revision of distal crural or pedal arteries. They incline to the present trend towards an aggressive approach if the revascularisation of the endangered limb is indicated. They identify with the opinion that high amputations represents a more serious stress on the patient than the revascularisation surgery. |
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