Záchrana kriticky ischemické končetiny -pedální bypass
| Title in English | Salvage of critically ischemic limg - pedal bypass grafting |
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| Authors | |
| Year of publication | 2005 |
| Type | Monograph |
| MU Faculty or unit | |
| Citation | |
| Description | The cause of chronic critical lower limb ischemia is often the combination of diabetic angiopathy and atherosclerotic disease of crural arteries. Foot gangrene is the terminal stage in this cases and the pedal bypass grafting is often the only method of limb salvage. The principle of this method is a bypass of the occluded crural arteries using an autologous venous graft with distal anastomosis to either the dorsal pedal artery or the posterior tibial artery below the ankle. Pedal bypass approach is based on the currently known fact that, even in patients with total occlusion of the crural arteries, the pedal arteries can be patent and the arterial reconstruction is possible. In spite of this, in some European surgical centers (including Czech Republic), pedal bypass grafting does not yet belong to standard surgical procedures. One of the reason could be the fact, that in patients with total occlusion of crural arteries, examained by preoperative angiography, contrast medium does not reach the most distal periphery of the limb and preoperative arteriographic findings are evaulated as unfavourable. Consequently, arterial reconstruction, the only procedure which could salvage the limb, is not indicated. In such cases it is necessary to perform the duplex scanning of the pedal arteries and, if this examination identifies the blood flow in the pedal arteries, pedal bypass grafting is indicated, despite the unsatisfactory angiographic finding. This approach could decrease the high number of a lower limbs amputations in the Czech Republic. |
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