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Article
December 6, 1919

AMPUTATION ABOVE THE LEVEL OF ARTERIAL OBSTRUCTIONIN ARTERIOSCLEROTIC GANGRENE

JAMA. 1919;73(23):1760. doi:10.1001/jama.1919.02610490024010

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Abstract

The tendency of the majority of surgeons in selecting the level at which to amputate in arteriosclerotic gangrene is to be guided by the extent of the area of gangrene. Not infrequently, the amputation is followed by extensive sloughing of the flaps and either death follows from sepsis, or, as in a case recently observed by us, the opposite limb becomes involved as the result of the extension of the thrombosis from the femoral to the iliac artery and then across to the opposite iliac artery. We have felt that the ideal method of choosing the level at which to amputate would be to expose the femoral artery at the middle of the thigh and to follow it in an upward or downward direction until a level was reached at which the thrombotic occlusion of the artery ceased, and distinct pulsation could be observed in the vessel. We have pursued

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