CHRONIC CRITICAL ISCHEMIA OF THE LOWER-LI MB - IS BYPASS-GRAFTING TO PEDAL ARTERIES WORTHWHILE

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