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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2007, Number 3

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Rev Mex Angiol 2007; 35 (3)

Experience in distal arterial derivations for rescue of inferior extremities in patients with critical ischemia in the Regional Hospital Licenciado Lopez Mateos, ISSSTE

Meza VMA, Serrano LJA, Sánchez NNE, Ramírez MC, Huerta HH, Flores EMH, Cisneros Tinoco MÁ, Jordán LJC, Rosas FMÁ, Flores NJF

Language: Spanish
References: 16
Page: 88-94
PDF size: 169.80 Kb.


ABSTRACT

Introduction: Patients with arterial occlusive disease (AOD) may course with lower extremity critical ischemia (LECI). The optimal technique of revascularization for limb salvage (LS) continues to be controvertial. Patency of infrapopliteal bypass apparently is less if compared to femoropoplyteal; though, the results are not concluding.
Objective: To show the experience in the management of patients with LECI, secondary to tibial vessel disease that are submitted to distal bypass for limb salvage.
Method: We included patients with LECI admitted to the Departament of Angiology and Vascular Surgery of the Regional Hospital Licenciado Adolfo Lopez Mateos, ISSSTE, during the period between March 2004 to June 2006, clinically with preserved poplyteal and femoral pulses, in absence of distal. We determined ankle-brachial index (ABI), evaluation with Doppler dupplex ultrasound and performed presurgical arterography or transoperatory, in searching of the distal outflow. We employed major safenous vein (MSV). We assessed the evolution of critical injuries and the performing of major and minor amputations.
Results: We performed 25 distal bypasses in 24 patients with LECI. We performed major amputations in five patients and minor amputations in 10 patients during the period already mentioned.
Conclusions: Distal arterial bypass with MSV are a proper choice for patients with LECI with tibial vessel disease for limb salvage. Though it is necessary to extend the follow up period to know the outcome in the long run.


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