Tibiotibial vein bypass grafts: A new operation for limb salvage

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Presentation transcript:

Tibiotibial vein bypass grafts: A new operation for limb salvage Frank J. Veith, M.D., Enrico Ascer, M.D., Sushil K. Gupta, M.D., Sheila White-Flores, B.S.N., Seymour Sprayregen, M.D., Larry A. Scher, M.D., Russell H. Samson, M.D. Journal of Vascular Surgery Volume 2, Issue 4, Pages 552-557 (July 1985) DOI: 10.1016/0741-5214(85)90008-4 Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Arteriogram performed on patient 3 years after posterior tibial-to-posterior tibial bypass. A shows pattern of disease typical for these patients, with unimpeded arterial flow into proximal tibial vessels and occlusion of all three leg arteries in mid or lower leg. B shows greater detail of bypass and outflow tract. Plantar arch is incomplete. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Intraoperative arteriogram after bypass from tibioperoneal trunk to posterior tibial artery at its bifurcation in foot. Note small size of vein graft and intact plantar arch. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Arteriogram obtained 6 months after bypass to anterior tibial artery; main trunk is totally obstructed distally. Large collateral branch supplies foot. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Intraoperative arteriogram after bypass from distal anterior tibial to dorsalis pedis artery. There is no patent plantar arch. This graft remains patent at 36 months. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Postoperative arteriogram after bypass to dorsalis pedis artery, which ends in total occlusion. There is also no patent plantar arch. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Digital venous arteriogram documenting graft patency 1 year after anterior tibial-to-anterior tibial artery bypass. This graft remains patent 23 months later. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 7 Cumulative life-table graft patency rate in 45 patients undergoing vein bypasses from below-knee popliteal artery to distal leg or foot artery. Number above each point represents number of grafts observed to be patent for that length of time. Journal of Vascular Surgery 1985 2, 552-557DOI: (10.1016/0741-5214(85)90008-4) Copyright © 1985 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions