Radial artery flow-through graft: A new conduit for limb salvage

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Presentation transcript:

Radial artery flow-through graft: A new conduit for limb salvage Victoria J. Teodorescu, MDa, Jin K. Chun, MDb, Nicholas J. Morrisey, MDa, Peter L. Faries, MDa, Larry H. Hollier, MDa, Michael L. Marin, MDa Journal of Vascular Surgery Volume 37, Issue 4, Pages 816-820 (April 2003) DOI: 10.1067/mva.2003.199 Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 1 A, In this 76-year-old woman with diabetes and hypertension, who had undergone femoral-tibial bypass grafting and amputation of the third, fourth, and fifth toes, acute graft occlusion developed just a few months after surgery, despite an adequate saphenous vein. Photograph shows healed right foot after revascularization with RAFT graft and split-thickness skin graft covering transmetatarsal amputation. Of interest, revascularization of the contralateral leg with use of the cephalic vein was required several months later. When this bypass occluded early postoperatively, the limb was amputed below the knee. The RAFT graft remains patent. B, Drawing of femoral-dorsalis pedis RAFT graft reconstruction with nonreversed saphenous vein. Note anastamosis of radial venae comitans to a perforating vein branch of the deep system. The RAFT flap was used to cover the dorsal incision. Journal of Vascular Surgery 2003 37, 816-820DOI: (10.1067/mva.2003.199) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions

Fig. 2 A, This 67-year-old man underwent two failed attempts at femoral-popliteal bypass grafting, but had progressively enlarging ulceration of the medial calf with exposure of tibial bone. A RAFT graft was chosen as the conduit because it afforded immediate coverage of the distal anastamosis. B, Healed left leg after femoral-posterior tibial bypass, constructed with reversed saphenous vein and RAFT graft. C, Drawing of femoral—posterior tibial reconstruction with a RAFT graft to reversed saphenous vein. An enlarged skin paddle was used for coverage of the open leg ulcer. The venae comitans of the radial artery was anastamosed to a saphenous vein branch. Journal of Vascular Surgery 2003 37, 816-820DOI: (10.1067/mva.2003.199) Copyright © 2003 Society for Vascular Surgery and The American Association for Vascular Surgery Terms and Conditions