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Distal Tibial Arterial Bypass Analysis of 91 Cases

George P. Noon, MD; Edward B. Diethrich, MD; William P. Richardson, MD; Michael E. DeBakey, MD
Arch Surg. 1969;99(6):770-775. doi:10.1001/archsurg.1969.01340180094019.
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Arterial reconstruction is now established treatment for occlusion of the superficial femoral and proximal popliteal arteries. Until recently, however, no direct surgical approach was available for increasing the blood supply in the legs of patients with occlusion of the distal popliteal and proximal tibial arteries. The only available treatment consisted in local care of the ischemic areas, administration of vasodilators, and performance of lumbar sympathectomy, many patients eventually requiring amputation of the diseased leg. Development of bypass procedures to the distal tibial arteries has enabled us to increase blood flow to the ischemic leg and provide considerable relief for most patients.1-7

Between May 1, 1965, and July 1, 1969, 91 patients with occlusive disease of the distal popliteal and proximal tibial arteries were treated with autogenous vein bypass grafts to the anterior tibial or posterior tibial artery at the ankle. These cases were reviewed in an attempt to determine


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