In 1958, we1 reported the early results of attempted arterial reconstruction in 137 limbs ischemic beyond simple claudication but not yet at the stage of fixed extensive gangrene. At that time, it seemed that apparently hopeless extremities often could be saved by sympathectomy, arterial reconstruction, or both. It is of interest that a similar study, reporting essentially identical results, was independently published at the same time by Roberts and Hoffman.2
Between 1958 and Jan 1, 1961, an additional 411 severely ischemic limbs were treated at the Cleveland Clinic, increasing the total to 548 lower extremities in 495 patients. This study was terminated on Jan 1, 1961, in order to obtain a follow-up period of at least one year on all patients studied. The maximum follow-up period is eight years after operation.
The etiology of the ischemia in all instances has been arteriosclerosis obliterans. Ischemic limbs resulting from embolus