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February 1980

Revascularization for Severe Limb Ischemia

Author Affiliations

From the Joseph Brown Whitehead Department of Surgery, Emory University School of Medicine, Atlanta.

Arch Surg. 1980;115(2):168-171. doi:10.1001/archsurg.1980.01380020036009

• Patients with rest pain or tissue necrosis (generally correlated with a tibial-brachial pressure index of less than 0.25) have a high probability of limb loss unless revascularization is done. These problems are usually associated with extensive and multiple segments of anatomical occlusive disease. A review of 359 patients with such problems indicates that revascularization was done in 86%, with initial success in 92% of patients. The durability of successful limb preservation proved good, with 90% of patients having a comfortable, useful limb to time of death or for one year or longer after operation. Cumulative patency rates were 90% at five years for aortofemoral reconstructions, 70% at five years for femoropopliteal bypasses, and 49% at five years for femorotibial grafts. Cumulative limb salvage rates were 93%, 81%, and 67% at five years in the same categories, respectively.

(Arch Surg 115:168-171, 1980)