Abstract
Interval gangrene is a rare but devastating complication after a successful peripheral revascularization procedure. It represents ischemic necrosis in a seg ment proximal to a functioning distal anastomosis and may develop when a bypassed segment is deprived of good perfusion. The patient here described underwent a femoroperoneal bypass because of severe atherosclerosis, with is chemia in the left lower extremity. Despite a good functioning bypass and a warm foot, she postoperatively developed ischemia of an area in the lower limb proximal to the distal anastomosis and eventually required above-knee amputa tion.
This case emphasizes the need for maintaining good perfusion of the entire lower limb after successful distal extremity bypass, which may require adjunc tive procedures. The authors recommend, therefore, that intraoperative angi ography be performed routinely, not only to judge the anastomosis and the distal perfusion, but also to assess the adequacy of antegrade and retrograde perfusion of the bypassed segment. Thus measures can be taken in time for optimal prevention of interval gangrene.
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