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May 1983

Distal Tibial Vein Grafts for Limb Salvage

Author Affiliations

From the Department of Surgery, Vascular Section, St John's Mercy Medical Center, St Louis.

Arch Surg. 1983;118(5):597-602. doi:10.1001/archsurg.1983.01390050069013

• Bypasses below the tibial peroneal trunk, which are not commonly performed, are an effective method of limb salvage. We have done long-term follow-up of all 148 consecutive grafts done during the past 19 years. By careful patient selection, detailed arteriograms, utilization of veins from all extremities, meticulous operating technique, and noninvasive follow-up, we have achieved a limb salvage rate of 75% and a cumulative five-year patency rate of 62%. Diabetics made up 53% of the series and did not affect the results. Seventy-one percent of all failures occurred in the first six months. Considering the charges for hospitalization, amputation, prostheses, and rehabilitation, distal tibial bypass procedures are cost-effective.

(Arch Surg 1983;118:597-602)