J.Jpn. Surg. Soc.. 82(11): 1377-1389, 1981

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Original article

EXPERIMENTAL AND CLINICAL STUDIES ON FREE OMENTAL TRANSPLANTATION FOR ISCHEMIC LEG

Experimental and clinical studies on revascularized free omental graft as a revascularization procedure for ischemic lower extremities were carried out. In the experimental study using dogs, development of numerous vascular communications between the implanted omental graft and ischemic extremity, and significant increase of blood flow was demonstrated at 6 weeks when the patency of the omental artery was kept for al ong time. However, when the patency of the omental artery was failed, few vascular communications with poor increase of blood flow was developed. Since these results revealed that patency of the graft artery was essential for achieving the success of this method, we developed a modified procedure to keep well the patency, which involves the A-V shunt between the implanted gastroepiploic artery and the host vein. Nine patients with extensive arterial occlusive lesions of the lower extremity underwent omental graft procedures, including 4 modified and 4 standard free grafts and 1 pedicled graft. Excellent improvement for ischemic symptoms was obtained in 3 of 4 cases with modified graft.

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