Distal bypass to a critically ischemic foot increases the skin perfusion pressure at the opposite site of the distal anastomosis

• Published in: Vascular Vol. 24; no. 4; p. 361
• Main Authors: Mochizuki, Yasuaki, Hoshina, Katsuyuki, Shigematsu, Kunihiro, Miyata, Tetsuro, Watanabe, Toshiaki
• Format: Journal Article
• Language: English
• Published: England 01.08.2016
• Subjects: Adult; Aged; Aged, 80 and over; Amputation; Anastomosis, Surgical; Angiography; Critical Illness; Female; Foot - blood supply; Humans; Ischemia - diagnosis; Ischemia - physiopathology; Ischemia - surgery; Limb Salvage; Male; Middle Aged; Predictive Value of Tests; Recovery of Function; Regional Blood Flow; Retrospective Studies; Saphenous Vein - transplantation; Skin - blood supply; Time Factors; Treatment Outcome; Vascular Grafting - adverse effects; Vascular Grafting - methods; Vascular Patency; Critical limb ischemia; distal bypass; pedal arch connection; skin perfusion pressure
• ISSN: 1708-539X
• DOI: 10.1177/1708538115597605

The purpose of the study was to reveal the effect of blood flow supply to the foot by analyzing the skin perfusion pressure values and the pedal arch connection after bypass surgery. We selected 48 operated limbs whose skin perfusion pressure was measured pre- and post-operatively on the opposite site of distal anastomosis. We also assigned the ischemic limbs to three groups according to the patency of the pedal arch: good, intermediate, and poor. The mean value of skin perfusion pressure increased significantly from 27.0 ± 14.9 to 52.8 ± 16.0 (p < 0.001) post-operatively. Skin perfusion pressure improved in most of the limbs post-operatively and decreased or unchanged in only four limbs, all of which showed improved tissue loss. Three amputated limbs were due to infection, and all showed an increase in skin perfusion pressure. It was difficult to correlate limb prognosis to skin perfusion pressure and the pedal arch connection.