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Anatomy and Technique SECTION EDITOR: Andris Kazmers, MD, MSPH MEDICAL ILLUSTRATIONS: Richard A. Gersony, MFA DOI: 10.1007/s100169910052 Gregory J. Landry, MD, Gregory L. Moneta, MD, Lloyd M. Taylor, Jr., MD, and John M. Porter, MD, Portland, Oregon Freeman and Leeds performed the first extraana- PREOPERATIVE CONSIDERATIONS tomic bypass in 1952 using an endarterectomized Noninvasive vascular examination of the lower ex- superficial femoral artery tunneled subcutaneously tremities is required to document the severity of to the contralateral femoral artery. The first axil- ischemia. In our practice, complete lower extremity lofemoral bypasses for lower extremity ischemia arteriography is obtained in elective cases. Ad- were independently reported by Blaisdell and equacy of axillary inflow is, however, usually as- Louw in 1963. Sauvage and Wood reported the sessed with noninvasive vascular laboratory testing first axillobifemoral bypass for bilateral lower ex- alone. Segmental pressure measurements and tremity ischemia in 1966. Although axillobifemo- Doppler analog waveforms are obtained at the level ral bypass has largely been regarded as a second- of the radial, ulnar, and brachial arteries in both choice alternative to standard aortoiliac and aorto- arms. A pressure difference >15 mmHg in values for femoral reconstructions, it is our opinion that both arms indicates
Annals of Vascular Surgery – Springer Journals
Published: Feb 18, 2014
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