Arterialisation of great saphenous vein in patient with critical limb ischemia: Case report

Abstract

Critical lower limb ischemia in the absence of distal arterial circulation presents an urgent situation, which must be treated immediately if we want to save the foot or limb from amputation.The reduced arterial ow in these situations is not adequate to provide metabolic requirements of lower limb even in rest.According to Fountain these patients are classi ed in Class III or in Class IV.Approximately 14%–20% of patients with critical lower limb ischemia are unsuited for distal arterial reconstruction and face major distal amputation [1]. Distal venous arterialization is a unique procedure in which the venous bed is used as an alternative conduit for perfusion of peripheral tissues of lower limb. Patients with critical lower limb ischemia can be treated by arterialization of great saphenous vein.Case reportIn the present article, we describe the rst case of in situ arterialization of great saphenous vein performed in Macedonia in treatment of critical below-knee ischemia. Maintaining the great saphenous vein in situ allows the arterialization of the foot venous arch with one anastomosis without removing the vein of its original bedConclusionDistal revascularization of the limb with critical ischemia, by creating a reverse ow with in situ saphenous vein arterialization must be seriously considered as an attempt for salvage of the foot or below-knee without distal arterial run-o .