Controlled ischemia for complex venous surgery: The technique of choice

Surgery under controlled ischemia has been extensively practiced by cardiac , plastic, orthopedic, vascular, and general surgeons. During the past 20 y ears, we have routinely used this technique to operate on a dean, bloodless field in complex cases of congenital vascular malformations. Based on our favorable experience, we have extended the use of the pneumatic tourniquet to complex cases of primary varicose veins. The use of the tourniquet has d ramatically decreased the blood loss and operating time in complex venous s urgery without complications secondary to its use. This technique represent s a welcome alternative to the bloody, tedious, and time-consuming traditio nal varicose vein surgery of the past. Complex venous surgery for extensive varicose veins of the extremities can be safely and expeditiously performe d under controlled ischemia. It should be the technique of choice.