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Article
September 1960

Limb Salvage in Occlusive Arterial Disease of the Lower ExtremitiesRecent Changes in the Surgical Approach

Author Affiliations

Chicago
Present Address of Dr. Bernhard: Department of Surgery, Marquette University School of Medicine, Milwaukee.; From the Departments of Surgery, North-western University Medical School, Veterans Administration Research Hospital, and Passavant Memorial Hospital.

Arch Surg. 1960;81(3):357-366. doi:10.1001/archsurg.1960.01300030017003
Abstract

Introduction  During the past decade the development of techniques for direct reconstruction of peripheral arteries has permitted the salvage of an increasing number of limbs which would otherwise have been consigned to amputation. Although lumbar sympathectomy alone may have considerable value in the palliative treatment of occlusive arterial disease of the lower extremities, it has become apparent that direct restoration of blood flow in major vessels, when applicable, is more effective for limb salvage. However, is seems that bypass techniques currently employed are not practicable when arteriosclerotic involvement of the distal popliteal artery causes marked narrowing or occlusion of this vessel sufficient to prevent construction of an adequate distal anastomosis. Rather than to consign patients who have inadequate distal run-off to a painful, useless existence until amputation is inevitable, we have attempted to broaden the indications for reconstructive arterial surgery by offering "extensive" endarterectomy to such patients.We are indebted

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