Retrograde perfusion of the hind leg in diabetic patients suffering from arteriosclerosis obliterans: Theoretical considerations of oxygen supply and lymphatic flow based on rat models

Abstract

To establish the physiological basis for vascular surgery involving arterio-venous anastomosis in diabetic patients, the question of oxygen supply and lymphatic outflow has been considered in rat skeletal muscles. The dense venular network in the skeletal muscle means that each tissue domain area is small enough to allow adequate oxygenation, consistent with the successful vascular surgery in patients. While sufficient oxygenated blood can reach the resting skeletal muscle through the bypass, there is concern that the resulting high venous pressure might produce a marked increase in lymphatic outflow and destroy the veins and lymphatic system. Consideration of filterability and total surface area of the venular tube now suggests the increase in lymphatic outflow would be only slight. Consideration of filterability and total surface area suggests the increase in lymphatic outflow would be tolerable for the lymphatic system in the hind limb. © 2012 Springer Science+Business Media, LLC.