[Amputation or circulatory reconstruction in critical chronic ischemia of the lower extremities]

As a rule, leg amputations in the elderly lead to an inability to walk and as a consequence to nursing-home care. The loss of body integrity and of psycho-social roots are responsible for the high mortality of 60% or more during in the first year after amputation. In case of imminent amputation, the crural arteries are almost always involved in the process of vascular occlusion. Only during the last 10 years has vascular surgery in the crural area become possible. Today crural reconstructions have a primary success-rate of over 90%, and in 60% of patients the leg can be saved in the long run. Even better long-term results may be expected through interdisciplinary collaboration and by the integration of microsurgical techniques.