During the past three years, we have had the opportunity to treat some 75 patients for peripheral arterial disease. In their management, currently accepted methods for translumbar aortography and femoral arteriography1,2 were utilized to supplement clinical diagnosis, and the usual methods for thromboendarterectomy,3 lumbar sympathectomy,4 and introduction of arterial grafts5-8 were applied. However, along with the good results that followed these methods, we have had some sobering experiences, emphasizing that success depends not only on proper diagnosis and surgical techniques but also on a number of extraneous factors that sometimes cannot be accurately delineated. This article emphasizes some of these factors. Most of them are hemodynamic. For the most part, the role they might play in a specific instance is difficult to predict before operation. Yet the possibility of their existence must be constantly kept in mind in evaluating patients with peripheral vascular disease.
THOMAS G. BAFFES, CLARENCE NORBERG, SPYROS KATOPODIS. Some Problems Encountered in Treatment of Peripheral Arterial Disease. AMA Arch Surg. 1959;79(1):52–62. doi:10.1001/archsurg.1959.04320070056010