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Surgical result of critical limb ischemia due to tibial arterial occlusion in patients with systemic scleroderma  Juno Deguchi, MD, PhD, Kunihiro Shigematsu,

Published byYandi Sudjarwadi Modified over 6 years ago

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Presentation on theme: "Surgical result of critical limb ischemia due to tibial arterial occlusion in patients with systemic scleroderma  Juno Deguchi, MD, PhD, Kunihiro Shigematsu,"— Presentation transcript:

1 Surgical result of critical limb ischemia due to tibial arterial occlusion in patients with systemic scleroderma  Juno Deguchi, MD, PhD, Kunihiro Shigematsu, MD, PhD, Satoshi Ota, MD, PhD, Hideo Kimura, MD, PhD, Masashi Fukayama, MD, PhD, Tetsuro Miyata, MD, PhD  Journal of Vascular Surgery  Volume 49, Issue 4, Pages (April 2009) DOI: /j.jvs Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 Preoperative arteriograms. A, Arteriography of the left leg revealed multiple lesions of the tibial arteries in patient 1. The superficial femoral and popliteal arteries were almost normal. B, Arteriography of the right leg showed occlusion of all three tibial arteries and development of collaterals in patient 2. Note the smooth popliteal artery without significant atherosclerosis. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 Arteriogram one month after bypass surgery in patient 1. A, Lateral view of upper part of sequential bypass. B, AP view of lower part of sequential bypass. It shows sequential pedal artery bypass (from proximal popliteal to peroneal to posterior tibial artery at the ankle). Note neither anastomotic site showed substantial intimal thickening. Arrowhead indicates the proximal anastomotic site of the graft. Arrow indicates the distal anastomotic site of the bypass. C, D, E, F, Histological findings in amputated limb of patient 1. Histological examination of a transverse section shows severe intimal thickening of the artery at the proximal anastomotic site (C, Elastica von Gieson, D, Hematoxylin and eosin staining). E, High power field of D. Note myofibrous proliferation with myxoid change. F, Transverse section of distal anastomotic site of the artery shows narrowing of the lumen with intimal thickening. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

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