Related Experiment Videos
External iliac ligation and axillary-bifemoral bypass for blue toe syndrome
Insights
Atheroemboli from the abdominal aorta can cause severe lower extremity issues. External iliac artery ligation combined with axillary-bifemoral bypass effectively saves limbs in high-risk patients.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
Background:
- Describes six patients with atheroemboli to both lower extremities originating from the abdominal aorta.
- Patients presented with severe bilateral rest pain, ulceration, or gangrene.
- All patients had severe coronary artery disease and comorbidities precluding direct aortic reconstruction.
Purpose of the Study:
- To evaluate the efficacy of external iliac artery ligation and axillary-bifemoral bypass for limb salvage in patients with atheroemboli.
- To prevent further embolization to the lower extremities.
Main Methods:
- Ligation of the external iliac arteries to halt emboli passage.
- Revascularization performed using axillary-bifemoral bypass.
Main Results:
- Successful initial limb salvage in twelve threatened extremities.
- One patient required a toe amputation; one axillary graft failure was managed with contralateral grafting.
- Long-term follow-up (up to 52 months) showed no limb loss, with a mean follow-up of 2.5 years.
Conclusions:
- External iliac ligation and axillary-bifemoral bypass is an effective and durable procedure.
- This combined approach prevents worsening ischemia and salvages threatened lower extremities in patients with blue toe syndrome and severe coronary artery disease.
Background:
This report describes six patients with atheroemboli to both lower extremities that originated from the abdominal aorta. All patients had severe bilateral rest pain and ulceration or gangrene. Each had severe coronary artery disease and other medical problems, which precluded direct aortic reconstruction.
Methods:
Ligation of the external iliac arteries was performed to prevent continual passage of emboli into the lower extremities. Revascularization was effected by axillary-bifemoral bypass.
Results:
Initial limb salvage was accomplished in twelve threatened extremities. One patient required a single toe amputation. One axillary graft failed after 3 months and was successfully replaced with a contralateral graft. These patients have been followed for up to 52 months without limb loss; the mean follow-up is almost 2 1/2 years.
Conclusions:
In patients with severe coronary artery disease and blue toe syndrome, the combination of external iliac ligation and axillary-bifemoral bypass is an effective and durable procedure to prevent worsening ischemia and to salvage threatened lower extremities.