Abstract：
:A 25-year-old man was admitted to our hospital for treatment of a painful ulcer on his left fourth toe, 9 years after undergoing lumbar sympathectomy and 4 years after undergoing bypass, both of which had been unsuccessful. Angiography demonstrated diffuse arterial occlusion in the lower extremities except for a persistent sciatic artery and a sural artery, which was the main collateral. Thus, reversed bifurcated saphenous vein bypass from the sciatic artery to the sural artery and the posterior tibial artery was performed utilizing Esmarch's rubber bandage as a substitute for a vascular clamp to control bleeding intraoperatively. The ulcer healed promptly and the patient was discharged symptom-free 1 month postoperatively. This case report demonstrates the advantage of performing collateral arterial bypass and illustrates some of the technical challenges associated with this procedure.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Shindo S,Kamiya K,Suzuki O,Kobayashi M,Tada Ydoi
10.1007/BF00309397subject
Has Abstractpub_date
1995-01-01 00:00:00pages
92-5issue
1eissn
0941-1291issn
1436-2813journal_volume
25pub_type
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