Edema after lower limb arterial reconstruction. Influence of background factors, surgical technique and potentially...

The pathogenesis of lower leg edema regularly following a distal arterial reconstruction is unclear and generally no treatment is used. In 85 patients background factors such as diabetes, age, sex and side of operation were analysed and found not to influence the degree of edema. A significantly less pronounced edema was found when a prosthetic graft was used as compared to a vein graft as well as if the distal anastomosis was located above as compared to below the knee. Both these findings might be explained by differences in incisions. In a pilot series the prophylactic effect of various pharmacological regimens was studied and in another 22 patients leg elevation was prescribed. None of the drugs (furosemide, mannitol, terbutaline and corticosteroids) appeared to prevent the development of edema. Within the leg elevation group there was, like in patients without special treatment, less swelling if the distal anastomosis was performed above the knee and if a prosthetic graft was used. In these cases leg elevation seemed to prevent swelling with significantly less edema than corresponding patients treated without leg elevation.