Arm veins are now well established as versatile arterial conduits for infrainguinal arterial reconstruction. Although cephalic veins were demonstrated to be effective for leg revascularization in 1969, they did not receive wide application until the early 1980s. By that time…
Bypass to infrageniculate arteries for chronic limb-threatening ischemia continues to provide a most challenging aspect of arterial reconstruction confronting vascular surgeons today. Their length and low flow all too often exceed the functional limits of synthetic and often even of…
The superficial femoral artery (SFA) is the infrainguinal vessel most commonly involved with severe atherosclerotic occlusive disease. Thus, it is not surprising that vascular surgeons have been reluctant to accept the concept of preferentially using an inflow site distal to…
Vein bypass grafting for lower extremity occlusive disease remains the gold standard against which new reconstructive techniques are compared. The greater saphenous vein (GSV) is the optimal conduit for the vein bypass and may be employed in either a reversed…
A broad knowledge accumulated from our experience with duplex imaging during a variety of vascular interventions supports a number of its valuable and unique features, including visualization of the vessel wall, substantial (up to five times) vascular magnification, precise measurements,…
Endovascular therapy has evolved into an attractive first-line therapy for patients with peripheral arterial occlusive disease. Plaque excision techniques, such as atherectomy and laser ablation, attempt to improve primary patency as a standalone procedure or in conjunction with balloon angioplasty.…
The poor early results and marginal long-term durability of percutaneous transluminal angioplasty in the femoropopliteal segment has prompted growing interest in covered stents in the treatment of occlusive disease. The potential advantages of a minimally invasive internal bypass are significant.…
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Medical therapy is essential in management of any patient with peripheral arterial disease, regardless of the extent of disease, symptoms, or plans for intervention. Physician-supervised walking programs have been shown to improve symptoms and quality of life in patients with…
After confirmation of peripheral arterial disease (PAD) by physical examination and Doppler ankle-to-brachial indices (ABIs), further radiologic testing, such as computed tomography angiography (CTA), magnetic resonance angiography (MRA), or intraarterial angiogram, may be performed to further localize and potentially treat…