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Pedal branch arterial bypass for limb salvage
Steven G Friedman1, Toufic K Safa
1Division of Vascular Surgery, North Shore University Hospital, Manhasset, New York 11030, USA.
The American Surgeon
|May 16, 2002
Summary
Pedal artery branch bypasses offer a viable alternative to amputation for critical limb ischemia. These bypasses achieve significant limb salvage and improved survival rates, making them a superior option to primary amputation.
Area of Science:
- Vascular Surgery
- Reconstructive Surgery
Background:
- Critical lower extremity ischemia often involves occlusion of distal tibial and pedal arteries.
- Primary amputation is frequently considered when traditional bypass targets are unavailable.
Purpose of the Study:
- To evaluate the efficacy of pedal branch arterial bypasses in patients with critical lower extremity ischemia.
- To compare the outcomes of pedal branch bypasses with existing literature on similar procedures.
Main Methods:
- Retrospective review of 22 pedal branch arterial bypass cases over a 12-year period.
- Inclusion of data from six additional published reports on pedal branch bypasses.
Main Results:
- The study achieved a cumulative primary graft patency rate of 72% at 2 years.
- A cumulative limb salvage rate of 82% was observed within the same interval.
- Literature review indicated comparable patency and salvage rates in approximately 200 other cases.
Conclusions:
- Pedal branch arterial bypasses provide comparable limb salvage rates to other infrainguinal bypasses.
- These bypasses are a crucial option for limb salvage in critical limb ischemia with distal arterial occlusion.
- Pedal artery branch bypasses represent a superior alternative to primary amputation, offering good functional outcomes.