[Recurrence of ischemia of the lower limbs in patients with functioning vascular prosthesis]

On the basis of experience in surgical treatment of 242 patients with recurrent ischemia of the lower limbs in late periods after operations on the aorta and peripheral arteries, the authors singled out a group of patients (44) with unobstructed but hemodynamically incompetent vascular prostheses. Their hemodynamic changes were caused by stenosis of the vascular anastomoses and shunts or by the development of occlusions of arteries beyond the reconstructed segments. The authors relate all these complications to the prethrombotic stage of late reocclusions and insist in their recognition before the development of thrombosis of the vascular prosthesis. The important role of dynamic Doppler flowmetry in early diagnosis is shown. Reoperations for correction of the blood flow were conducted on 40 patients. The results were good in 92.5% of them. The authors recommend wider use of preventive operations which contribute to the improvement of surgical treatment of patients with late reocclusions of arteries and vascular prostheses.