Dorsalis pedis arterial bypass: Durable limb salvage for foot ischemia in patients with diabetes mellitus Frank B. Pomposelli, MD, Edward J. Marcaccio,

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Presentation transcript:

Dorsalis pedis arterial bypass: Durable limb salvage for foot ischemia in patients with diabetes mellitus Frank B. Pomposelli, MD, Edward J. Marcaccio, MD, Gary W. Gibbons, MD, David R. Campbell, MD, Dorothy V. Freeman, MD, Anne M. Burgess, RN, Arnold Miller, MB, ChB, Frank W. LoGerfo, MD Journal of Vascular Surgery Volume 21, Issue 3, Pages 375-384 (March 1995) DOI: 10.1016/S0741-5214(95)70279-2 Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Intraarterial digital subtraction angiogram of proximal tibial and foot circulation in patient undergoing dorsalis pedis bypass. Below-knee popliteal, anterior tibial, and posterior tibial arteries are occluded. Peroneal artery reconstitutes distal to tibioperoneal trunk, which is occluded (left panel). Dorsalis pedis artery is widely patent (left panel) and fills part of metatarsal arch. Plantar arteries are occluded. Journal of Vascular Surgery 1995 21, 375-384DOI: (10.1016/S0741-5214(95)70279-2) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Popliteal-dorsalis pedis bypass with translocated nonreversed saphenous vein. Harvesting more proximal vein avoids second foot incision. Journal of Vascular Surgery 1995 21, 375-384DOI: (10.1016/S0741-5214(95)70279-2) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Cumulative primary and secondary patency rates of 384 vein grafts to dorsalis pedis artery. Journal of Vascular Surgery 1995 21, 375-384DOI: (10.1016/S0741-5214(95)70279-2) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Cumulative limb salvage and patient survival rates. Journal of Vascular Surgery 1995 21, 375-384DOI: (10.1016/S0741-5214(95)70279-2) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Life-table analysis of patency of 147 in situ saphenous vein grafts and 177 translocated reversed or nonreversed saphenous vein grafts (all ipsilateral saphenous vein). There is no significant difference noted at 5 years (p = 0.28). Journal of Vascular Surgery 1995 21, 375-384DOI: (10.1016/S0741-5214(95)70279-2) Copyright © 1995 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions