Tourniquets in arterial bypass surgery

Background: successful infra-popliteal bypass depends on precise, atraumati c technique in performing the distal anastomosis. The use of a tourniquet f acilitates the distal anastomosis, reducing dissection, avoiding traumatisi ng clamping of the vessels and providing an "uncluttered" operating field. Despite these advantages the technique is under-used. Objectives: to review the use of tourniquets in arterial reconstruction, wi th particular reference to safety issues and complications. Design, methods and materials: a Medline search was performed (last search Feb. 2000), and keywords from relevant papers were used to perform subseque nt searches. References were reviewed from each relevant paper. Results: no randomised controlled trials were found. The review details rep orted use of tourniquets in arterial reconstruction, including techniques, outcomes and potential complications. Conclusions: the use of a tourniquet is a safe and effective technique to f acilitate arterial reconstruction.