Arterial reconstruction to the foot vessels: is it worth the trouble?

Between 1974 and 1988, 32 patients with severe rest pain and ischemic ulcerations of lower extremities underwent 34 arterial reconstructions to the foot vessels, using, in the majority of cases, the in-situ vein technique. There were 10 early graft failures, resulting in the loss of five extremities. The indication for surgery, presence of diabetes and type of bypass were not predictive of early thrombosis. Five-year primary and secondary patency rates were 52.8% and 62.6%, with a foot salvage rate of 74%. Although a number of these long bypass grafts fail early because of the severity of tibial disease, this procedure appears to be durable in a selected group of patients.