J.Jpn. Surg. Soc.. 79(8): 682-687, 1978

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Report on the annual meeting

NEW DEVICE OF ACTIVE RECONSTRUCTIVE SURGERY FOR EXTENSIVE ARTERIAL OCCLUSION OF LOWER EXTREMITY
－A-V SHUNT PROCEDURE－

A new active reconstructive surgery, that is open endarterectomy of the occluded femoro-popliteal arteries with arteriovenous shunt (A-V shunt procedure), for the extensive arterial occlusive lesion of the lower extremity was devised. In this procedure, the patency of the reconstructed femoro-popliteal arteries are ensured by the distal arteriovenous shunt and considerable development of the collaterals through the reopened branches of the genicular network is expected. Elabolate removal of thrombi in the branches of the genicular network and creation of arteriovenous shunt at the site distal to the genicular network are necessary to get good effects. During the years 1967-1975, 59 extremities in 53 patients were operated on with this A-V shunt procedure, all of them had been suffered from extensive arterial occlusion of the lower extremity. Fourty-five out of fifty-nine extremities (76 per cent) had remarkable improvement of ischemic symptoms at discharge. Long-term effectiveness of the procedure was fiftyeight per cent (34/59) .

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