THERE are times when the surgeon is forced to make a prompt decision in cases of severe ischemia of an extremity in a poor risk patient. Although ingenious methods have been described to minimize the operative trauma involved, the usual operative procedures still impose considerable stress on the patient. The situation can be even more grave when the acute ischemia threatens gangrene of the extremity. For this reason the cross-over graft has been used in selected cases to relieve the ischemia secondary to the occlusion of an iliac or femoral artery1-4 even in the presence of impaired run-off.3 The purpose of the present report is to record two additional successful cases which further confirm the usefulness of cross-over grafts in poor risk patients.
Report of Cases
—An 85-year-old white woman was admitted to the University Medical Center on Sept 18, 1965, with severe ischemia of the