Reconstructive surgery for restoration of blood flow in case of chronic ischemia of the lower limb
A patient M.F., 74-year-old was admitted to Head and Neck Vessels Surgery Department of MC Erebouni (the Head Dr. M.P. Shatakhyan, MD.,PhD) with complaints of severe pains in the left lower limb starting while walking 15 meters. After physical examination of the patient (on the left leg the pulsation was presented only in the projection of common femoral artery) the Duplex scanning and CT-angiography of the abdomen and the vessels of lower limbs was carried out. In a result of examinations it was revealed a superficial femoral artery occlusion at the point of its branching up to the level of popliteal artery. On the arteries of the shin was observed poor collateral blood flow. To restore the blood flow in the leg and relief the decision to perform femoral - distal - popliteal bypass surgery was made.
In 20.05.16. by the surgical team (main surgeon Dr. M.P. Shataxyan., assistants surgeons Dr. A.A. Hayrapetyan, Dr. A.N. Aleqsanyan, Dr, N.Kh. Atanesyan, anesthesiologist Dr. A.R. Muradyan) the distal femoro-popliteal bypass surgery was carried out. Due to the lack of apropriate size of autovein (on average 2mm), a decision for doing bypass by using Vascutek vascular grafts 6mm was made. The proximal anastomosis was placed on common femoral artery, and the distal – on popliteal artery, lower of the knee joint. Both anastomoses were put “the end to the side” by continuous suture using Prolene 6-0. After placing bypass graft the pulsation on posterior tibial artery and foot dorsal artery became palpable. The patient was extubated.
Post-operative period was uneventful, with no special features. According to Duplex scanning data performed before being discharged, the blood flow on vascular graft and on tibial arteries was main type of flow within physiological values. The patient was discharged on the 5th day.
The open surgical interventions for revascularization of lower limbs are the most reliable and effective standard of the treatment of chronic ischemia and are being used in all leading clinics of the world for over 50 years.
In MC Erebouni the full range of surgeries for revascularization of limbs, regardless of the injury level are performed and often this method is the only alternative to amputation.