Measurement of Blood Pressure,Blood Flow and Flow Velocity in Arterial Reconstruction of the Lower Extremity

Abstract

Seventy-five limbs of 66 patients undergoing arterial reconstruction of the lower extremity were studied. In 41 of 64 limbs that were not involved in early failure, API returned to normal immediately and the increased API was main tained as long as grafts remained patent. The limbs exhibiting a rise in API of 0.1 or more following proximal reconstruction in the cases with combined iliac and femoral arterial occlusion or bypass grafting to an isolated segment ob tained marked improvement of symptoms. Postoperative increase in TPI was not so marked as in API, and TPI remained very low in the limbs with arterial obstructive lesions below the ankle after successful reconstruction. Early or late failure could not be predicted on the basis of preoperative or postoperative API, TPI or A-T gradient. In the limbs with no recovery of TPI, blood flow or flow velocity in the foot was of value predicting which limbs would be sal vaged.

Get full access to this article

View all access options for this article.

References

Bergan JJ and Tao Jst : Role of the vascular laboratory. Surg 88:9, 1980.

Shionoya S. , Masafumi Hirai , Kawai S. , et al: Hemodynamic study of ischemic limb by velocity measurement in the foot. Surg 90:10, 1981.

Dean RH , Yao Jst , Stanton PE and Bergan JJ : Prognostic indicators in femoropopliteal reconstruction. Arch Surg 110:1287, 1975.

Sumner DS and Strandness DE Jr: Hemodynamic studies before and after extended bypass grafts to the tibial and peroneal arteries. Surg 86:442, 1979.

Corson JD , Johnson WC , LoGerfo FW , et al: Doppler ankle systolic blood pressure. Prognostic value in vein bypass grafts of the lower extremity. Arch Surg 113:932, 1978.

Hirai M. and Shionoya S. : Segmental blood pressure of the leg and its clinical use. Jap J Surg 8:102, 1978.

Garrett WV , Slaymaker EE , Heintz SE and Barnes RW : Intraoperative prediction of symptomatic result of aortofemoral bypass from changes in ankle pressure index. Surg 82:504, 1977.

Shionoya S. , Hirai M. and Ohta T. : A prospective study of hemodynamic changes associated with distal arterial bypass in the leg. Thorac cardiovasc Surgeon 28:200, 1980.

Walker PM and Johnston Kwj : When does limb blood flow increase after aortoiliac bypass grafting? Arch Surg 115:912, 1980.

10.

Fronek A. , Johansen KH , Dilley RB and Bernstein EF : Noninvasive physiologic tests in the diagnosis and characterization of peripheral occlusive disease. Am J Surg 126:205, 1973.

11.

Sumner DS and Strandness DE Jr: Aortoiliac reconstruction in patients with combined iliac and superficial femoral arterial occlusion. Surg 84:348, 1978.