[Value and use of pedal reconstruction in an extremity at risk for amputation]

In patients with critical limb ischemia and patent pedal arteries as a single outflow source the surgeon has to decide between primary amputation and reconstruction. From 1989 to 1991 we performed 80 infrainguinal reconstructions, 13 of them to pedal arteries. In all cases we used autogenous vein material from different sources, if possible as an in situ conduit. The perioperative mortality was 0%. After 24 months the limb salvage was 92%. The secondary cumulative patency rate was 92% after 12, 74% after 24 months. In a selected group of patients we prefer arterial reconstruction to pedal arteries instead of a primary amputation.