EXPERIMENTAL AND CLINICAL-STUDIES ON ONE-STAGE ARTERIALIZATION OF THEVENOUS CHANNELS FOR REVASCULARIZATION OF SEVERELY ISCHEMIC LIMBS

A new approach to perfuse arterial blood through venous channels for r evascularization of severely ischemic limbs is reported. The procedure studied and used consists of creating an arteriovenous fistula betwee n the normal arterial trunk proximal to the occlusion and the deep ven ous trunk of the diseased limb, constricting the venous trunk proximal to the anastomosis to one third of its lumen diameter, ligating the c ommunicating and small tributary veins distal to the constriction in t he operative field. The results of the experimental and clinical studi es have shown that the treated ischemic limb was quickly revascularize d without undesirable influence on cardiac function. This new approach has been used in the treatment of severe ischemia involving total 212 limbs in 156 patients, and the results appeared more satisfactory tha n those treated with staged arteriovenous reversal.