[Arterialization of the distal veins of the foot for limb salvage in arteritis. Techniques and results].

Study Aim: The aim of this retrospective study was to report the long term results with arterialisation of the veins of the foot as the final attempt to save an ischaemic limb when classical techniques have proved ineffective or impossible.

Patients And Method: From January 1974 to July 2000, 60 arterialisations of the distal veins of the foot were performed in 59 patients with arteritis, associated in 25 of them with diabetes mellitus. There were 41 men and 18 women, their mean age was 72 years (range from 49 to 95 years).

Arteriovenous revascularization for lower limb salvage in unreconstructible arterial occlusive disease (long-term outcome).

Between February 1983 and June 1994 we attempted surgically to salvage twenty-six legs in twenty-five patients with insufficient distal run-off and severely ischemic feet; all of them had resting pain, and 23 had tissue necrosis. A saphenous venous graft was interposed between an artery of the lower extremity (femoral or popliteal) and the veins of the foot with obligatory end-to-side distal anastomosis. The patency of the venous circulation of the ischemic foot was ascertained by retrograde phlebography.

[Can distal vein arterialization be beneficial for the diabetic foot with necrosis?].

When arterial bypass cannot be used in cases of diabetic arteriopathy of the lower limbs, we have, since 1974, relied on the former method using the veins. Arterial blood is brought to the zone of ischaemia via an internal saphenous vein graft anastomosed distally to a vein in the foot, thus creating an arteriovenous fistula. Improvements in the technique include removing the valves in the dorsal venous arcade.

[Comparative study of two methods of arterialization of foot veins in ischemic crisis].

Between February 1974 and December 1991, a total of 28 arterializations of the venous network of foot were performed in patients with stage IIIB or IV arteriopathies presenting disseminated femoropopliteal and more distal lesions excluding revascularization by conventional arterial shunt operations. Two groups of patients could be distinguished. The first group, of 8 patients, underwent arterialization by shunt operation with end to end fistula at the distal part of leg and return blood emptying at the dorsal surface of foot (3 cases).

[Study of the veins of the foot by counter-current phlebography].

83 CF phlebographies of the foot veins were carried out in varicose vein sufferers of both sexes in order to better understand the return venous circulation of the foot in detail, its abnormalities, and also to attempt to explain edema of the foot suffered by many varicose vein patients to varying degrees of severity after saphenous stripping. Films were obtained by direct needle puncture at different sites on the fore-foot, after a tourniquet was placed around the ankle. The route taken by the contrast medium injected was followed on a fluoroscop screen and photographed.