Reconstructive arterial surgery for ischemic lower extremities

Patients with ischemic lower extremities who are to indergo arterial reconstruction must be carefully selected. A careful history and physical examination will disclose the point of obstruction and the degree of ischemia. Arteriography is essential for the determination of runoff adequancy below the point of obstruction and for selection of the best site for distal anastomosis. Various potential routes for bypass graft have been discussed and some of the factors that determine the procedure ultimately chosen have been presented. Types of graft materials currently enjoying popularity have been listed and the general techniques of operation have been outlined.