Abstract
Restoration of arterial flow to a severely ischemic extremity remains a major challenge in vascular surgery. The procedure of choice for limb salvage is a bypass utilizing reversed saphenous vein. When the saphenous vein is unsuitable or unavailable, the surgeon must turn to endarterectomy of the femoral and popliteal systems or synthetic, composite, heterologous, autologous, or homologous grafts. To avoid the problems associated with these techniques and to improve the results of limb salvage, we have revived and modified the technique of superficial femoral artery eversion endarterectomy and combined it with other reconstructive techniques in an effort to salvage the severely ischemic lower extremity. Of 38 patients treated for incapacitating claudication or severe limb ischemia during a one-year period, six patients had an unsuitable saphenous vein for the proposed reconstruction. Five of these patients underwent superficial femoral eversion endarterectomy. These six patients have 100% patency at follow-up seven months to one year postoperatively. Our experience with these six patients, including angiographic follow-up, will be presented.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Connolly J. E., Stemmer E. A. Eversion endarterectomy of the aortoiliofemoral arteries. A three-year experience. Arch Surg. 1970 Apr;100(4):461–469. doi: 10.1001/archsurg.1970.01340220137023. [DOI] [PubMed] [Google Scholar]
- Connolly J. E., Stemmer E. A. Simplified technique of eversion endarterectomy for aortoiliofemoral occlusive disease. Arch Surg. 1972 Sep;105(3):520–523. doi: 10.1001/archsurg.1972.04180090117028. [DOI] [PubMed] [Google Scholar]
- Harrison J. H., Jordan W. D., Perez A. R. Eversion thromboendarterectomy. Surgery. 1967 Jan;61(1):26–30. [PubMed] [Google Scholar]
- Imparato A. M., Bracco A., Kim G. E., Zeff R. Intimal and neointimal fibrous proliferation causing failure of arterial reconstructions. Surgery. 1972 Dec;72(6):1007–1017. [PubMed] [Google Scholar]
- Lord J. W., Jr, Sadranagani B., Bajwa G., Rossi G. New technique for construction of coposite Dacron vein grafts for femoro-distal popliteal bypass in the severely ischemic leg. Ann Surg. 1975 May;181(5):670–675. doi: 10.1097/00000658-197505000-00022. [DOI] [PMC free article] [PubMed] [Google Scholar]