Herstel van de circulatie in de voetarteriën ter behoud van het onderbeen

– During a period of five years 61 lower extremities in 58 patients were treated by anastomosing venous bypasses to arteries of the last 10 cm of the distal lower leg (27) or to the arteries of the foot (34). In all cases the patients suffered from rest pain or gangrene. The mean age was 68. years; 74 of the patients suffered from diabetes mellitus. As the occlusions were principally localised in arteries of the lower leg, the only alternative would have been a major amputation. In an attempt to decrease the outflow resistance a small side to side arteriovenous fistula to the concomitant vein was added to the distal anastomosis.

After a follow-up of 24.8 months the patency rate was 54. In the end 4661 (75) of the feet and the legs could be saved from amputation. During the follow-up 16 patients died, a follow-up mortality of 25. The hospital mortality was 3. In conclusion it is our opinion, that the negative assessment of the chance of saving patients‘ feet in the above mentioned situation is not justified.