DISTAL VEIN GRAFT RECONSTRUCTIONS FOR ISO LATED TIBIOPERONEAL VESSEL OCCLUSIVE DISEASE IN STAGE OF CRITICAL FOOT ISCHEMIA

Between May 1, 1986 and November 1, 1994 94 distal reconstructions wer e performed in diabetics with isolated tibioperoneal vessel occlusive disease. Mostly the below knee popliteal artery was used as inflow sit e and most grafts were anastomosed distally to a malleolar artery. Aut ologous vein was implanted throughout. Mortality at 30 days was 1,06%. Primary and secondary cumulative patency rates were 78% and 82% at I year, 65% and 78% at 5 fears. Limb salvage rates were 76% at 1 year an d 72% at 5 years. Major amputations became inevitable in 12 eases of u ncontrollable foot infections despite patent grafts. This is probably due to the diabetic immunopathy, The experience we have gained suggest s that distal bypasses in patients with peripheral vascular occlusive disease and critical foot ischemia are excellently suited to attain li mb salvage.