[Is the cost of pedal reconstructions justified in potential amputation of the lower extremity]

From May 1990 to April 1994 we performed 24 arterial reconstructions to pedal arteries in 23 patients. There were 12 women (52%) and 11 men (48%) suffering from chronic critical ischemia of the lower extremities. The 30 day-mortality was 9%. 3 early graft thromboses had to be corrected. This was successful in two cases, but failed in one case, making below knee amputation in this patient necessary. Another leg with a patent graft had to have a below-knee amputation due to persistent foot infection. Secondary procedures to correct graft stenoses were performed in 8 legs (33%). All patients entered a prospective surveillance program to study primary (64% at 12 months) and primary assisted patency rates (81% at 24 months). Limb salvage rate was 90% at 24 months. We think that reconstructions to pedal arteries are worthwhile in properly selected patients. Limbs can be salvaged in a high percentage improving quality of live considerably.