Skip to main content

Surgical Revascularization of Chronic Limb Ischemia

  • Chapter
  • First Online:
Critical Limb Ischemia

Abstract

Advances in endovascular techniques have allowed greater opportunities for limb salvage in the patient presenting with critical limb ischemia (CLI), with subsequent validation of an “endovascular-first” approach in these patients. However, failure to traverse the lesion and symptomatic recurrence of disease continue to be the so-called Achilles’ heels of endovascular therapy. Surgical revascularization therefore remains a crucial element of the limb salvage armamentarium.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Alexandrescu V, Soderstrom M, Venermo M. Angiosome theory: fact or fiction? Scand J Surg. 2012;101(2):125–31.

    Article  CAS  PubMed  Google Scholar 

  2. Schanzer A, Hevelone N, Owens CD, Belkin M, Bandyk DF, Clowes AW, et al. Technical factors affecting autogenous vein graft failure: observations from a large multicenter trial. J Vasc Surg. 2007;46(6):1180–90.

    Article  PubMed  Google Scholar 

  3. Akbari CM, Macsata R, Smith BM, Sidawy AN. Overview of the diabetic foot. Semin Vasc Surg. 2003;16(1):3–11.

    Article  PubMed  Google Scholar 

  4. Hertzer NR, Bena JF, Karafa MT. A personal experience with direct reconstruction and extra-anatomic bypass for aortoiliofemoral occlusive disease. J Vasc Surg. 2007;45(3):527–35.

    Article  PubMed  Google Scholar 

  5. Aburahma AF, Robinson PA, Cook CC, Hopkins ES. Selecting patients for combined femorofemoral bypass grafting and iliac balloon angioplasty and stenting for bilateral iliac disease. J Vasc Surg. 2001;33 Suppl 2:S93–9.

    Article  CAS  PubMed  Google Scholar 

  6. Gupta AK, Bandyk DF, Cheanvechai D, Johnson BL. Natural history of infrainguinal vein graft stenosis relative to bypass grafting technique. J Vasc Surg. 1997;25(2):220–5.

    Article  Google Scholar 

  7. Miller A, Stonebridge PA, Tsoukas AI, Kwolek CJ, Gibbons GW, et al. Angioscopically directed valvulotomy: a new valvulotome and technique. J Vasc Surg. 1991;13(6):813–20.

    Article  CAS  PubMed  Google Scholar 

  8. Santo VJ, Dargon PT, Azarbal AF, Liem TK, Mitchell EL, Moneta GL, et al. Open versus endoscopic great saphenous vein harvest for lower extremity revascularization of critical limb ischemia. J Vasc Surg. 2014;59(2):427–34.

    Article  PubMed  Google Scholar 

  9. Reed AB, Conte MS, Belkin M, Mannick JA, Whittemore AD, Donaldson MC. Usefulness of autogenous bypass grafts originating distal to the groin. J Vasc Surg. 2002;35(1):54–5.

    Article  Google Scholar 

  10. Hughes K, Domeniq CM, Hamdan AD, Schermerhorn M, Aulivola B, Blattman S, et al. Bypass to plantar and tarsal arteries: an acceptable approach to limb salvage. J Vasc Surg. 2004;40(6):1149–57.

    Article  PubMed  Google Scholar 

  11. Chew DK, Owens CD, Belkin M, Donaldson MC, Whittemore AD, Mannick JA, et al. Bypass in the absence of ipsilateral greater saphenous vein: safety and superiority of the contralateral greater saphenous vein. J Vasc Surg. 2002;35(6):1085–92.

    Article  PubMed  Google Scholar 

  12. Faries PL, Arora S, Pomposelli Jr FB, Pulling MC, Smakowski P, Rohan DI, et al. The use of arm vein in lower-extremity revascularization: results of 520 procedures performed in eight years. J Vasc Surg. 2000;31(1 Pt 1):50–9.

    Article  CAS  PubMed  Google Scholar 

  13. Simons JP, Schanzer A, Nolan BW, Stone DH, Kalish JA, Cronenwett JL, et al. Outcomes and practice patterns in patients undergoing lower extremity bypass. J Vasc Surg. 2012;55(6):1629–36.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Albers M, Battistella VM, Romiti M, Rodriques AA, Pereira CA. Meta-analysis of polytetrafluoroethylene bypass grafts to infrapopliteal arteries. J Vasc Surg. 2003;37(6):1263–9.

    Article  PubMed  Google Scholar 

  15. Griffiths GD, Nagy J, Black D, Stonebridge PA. Randomized clinical trial of distal anastomotic interposition vein cuff in infrainguinal polytetrafluoroethylene bypass grafting. Br J Surg. 2004;91(5):560–2.

    Article  CAS  PubMed  Google Scholar 

  16. Chang CK, Scali ST, Feezor RJ, Beck AW, Waterman AL, Huber TS, et al. Defining utility and predicting outcome of cadaveric lower extremity bypass grafts in patients with critical limb ischemia. J Vasc Surg. 2014;14(1):1120–3.

    Google Scholar 

  17. LaMuraglia GM, Conrad MF, Chung T, Hutter M, Watkins MT, Cambria RP. Significant perioperative morbidity accompanies contemporary infrainguinal bypass surgery: an NSQIP report. J Vasc Surg. 2009;50(2):299–304.

    Article  PubMed  Google Scholar 

  18. Goshima KR, Mills Sr JL, Hughes JD. A new look at outcomes after infrainguinal bypass surgery: traditional reporting standards systematically underestimate the expenditure of effort required to attain limb salvage. J Vasc Surg. 2004;39(2):330–5.

    Article  PubMed  Google Scholar 

  19. Fischer JP, Nelson JA, Rohrbach JI, Wu LC, Woo EY, Kovach SJ, et al. Prophylactic muscle flaps in vascular surgery: the Penn Groin Assessment Scale. Plast Reconstr Surg. 2012;129(6):940e–49e.

    Google Scholar 

  20. Chiu KW, Davies RS, NIghtingale PG, Bradbury AW, Adam DJ. Review of direct anatomical open surgical management of atherosclerotic aorto-iliac occlusive disease. Eur J Vasc Endovasc Surg. 2010;39(4):460–71.

    Article  CAS  PubMed  Google Scholar 

  21. Kim YW, Lee JH, Kim HG, Huh S. Factors affecting the long-term patency of crossover femorofemoral bypass graft. Eur J Vasc Endovasc Surg. 2005;30(4):376–80.

    Article  CAS  PubMed  Google Scholar 

  22. Soma G, Greenblatt DY, Nelson MT, Rajamanickam V, Havlena J, Fernandes-Taylor S. Early graft failure after infrainguinal arterial bypass. Surgery. 2014;155(2):300–10.

    Article  PubMed  Google Scholar 

  23. Tinder CN, Chavanpun JP, Bandyk DF, Armstrong PA, Back MR, Johnson BL, et al. Efficacy of duplex ultrasound surveillance after infrainguinal vein bypass may be enhanced by identification of characteristics predictive of graft stenosis development. J Vasc Surg. 2008;48(2):613–8.

    Article  PubMed  Google Scholar 

  24. Pulli R, Dorigo W, Castelli P, Dorucci V, Ferilli F, De Blasis G, et al. Midterm results from a multicenter registry on the treatment of infrainguinal critical limb ischemia using a heparin-bonded ePTFE graft. J Vasc Surg. 2010;51(5):1164–77.e1.

    Google Scholar 

  25. Dorigo W, Pulli R, Castelli P, Dorrucci V, Ferilli F, De Blasis G, et al. A multicenter comparison between autologous saphenous vein and heparin-bonded expanded polytetrafluoroethylene (ePTFE) graft in the treatment of critical limb ischemia in diabetics. J Vasc Surg. 2011;54(5):1332–8.

    Article  PubMed  Google Scholar 

  26. Nicoloff AD, Taylor Jr LM, McLafferty RB, Moneta GL, Porter JM. Patient recovery after infrainguinal bypass grafting for limb salvage. J Vasc Surg. 1998;27(2):256–63.

    Article  CAS  PubMed  Google Scholar 

  27. Bradbury AW, Adam DJ, Bell J, Forbes JF, Fowkes FG, Gillespie I. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg. 2010;51 Suppl 5:5S–17S.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Pradka, S.P., Ornekian, V., Akbari, C.M. (2017). Surgical Revascularization of Chronic Limb Ischemia. In: Dieter, R., Dieter, Jr, R., Dieter, III, R., Nanjundappa, A. (eds) Critical Limb Ischemia. Springer, Cham. https://doi.org/10.1007/978-3-319-31991-9_36

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31991-9_36

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31989-6

  • Online ISBN: 978-3-319-31991-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics