Surgical management: Open surgical treatment of infra-inguinal occlusive disease

Abstract

Infra-inguinal occlusive disease in diabetic and non-diabetic patients without treatment carries a significant risk of minor and major amputation as well as death. There are different modalities in treating peripheral arterial disease including bypass surgery and angioplasty. Several investigations have studied the outcomes in both modalities. Hybrid techniques using different revascularisation strategies have also been used especially in complex and redo-cases. In this chapter the authors are addressing the different diagnostic modalities in critical leg ischaemia and the planning of surgical treatment in these patients. The outcome of distal and ultra-distal bypass surgery in the literature is also examined and the means of improving bypass outcome and follow-up are highlighted. Finally the role of arterial bypass and other modalities is briefly discussed in the treatment of acute lower limb ischaemia.