Hyperaemia of the calf after arterial reconstruction for atherosclerotic occlusion. A plethysmographic study

Wellington, J L; Olszewski, Vanessa; Martin, Peter

doi:10.1002/bjs.1800530306

Cited by 13 publications

(3 citation statements)

References 4 publications

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“…The magnitude of the hyperemic response was found by several authors to correlate with the severity of the ischemia. 4,19-21 Sumner and Folse 20 demonstrated that post-reconstructive hyperemic legs exhibited only a limited capacity to respond to stimuli which usually produce vasodilation or vasoconstriction compared with the normal legs. In view of the above findings, hyperemia is suggested to attribute to edema formation; however, no correlation was found between the disturbances in local blood flow regulation and edema using the 133 Xenon technique in a study by Eickhoff and Engell.…”

Section: Methodsmentioning

confidence: 99%

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Pathophysiology and treatment of edema following femoropopliteal bypass surgery

Slaa

Dolmans

et al. 2012

Vascular

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Substantial lower-limb edema affects the majority of patients who undergo peripheral bypass surgery. Edema has impairing effects on the microvascular and the macrovascular circulation, causes discomfort and might delay the rehabilitation process of the patient. However, the pathophysiology of this edema is not well understood. The Cochrane Library and Medline were used to retrieve literature on edema following peripheral bypass surgery. Factors other than local wound healing alone are suggested in the literature to play a role, given the severity and duration of this edema. Hyperemia, microvascular permeability, reperfusion-associated inflammation and lymphatic disruptions are likely to facilitate the development of edema. Preventive methods could be lymphatic-sparing surgery, intraoperative antioxidative therapy and postoperative elevation. Successful treatment strategies to reduce postoperative edema are based on lymph massage and external compression. In conclusion, the pathophysiology of edema following peripheral surgery is not fully understood, although reperfusion-associated inflammation and lymphatic disruptions are likely to play a crucial role. When future less-invasive techniques prove to be successful, postoperative edema might be minimized. Until then, a careful lymphatic-sparing dissection should be executed when performing a peripheral bypass reconstruction. Postoperatively, the use of compression stockings and leg elevation are currently the golden standards.

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Section: Methodsmentioning

confidence: 99%

“…Structural damage of resistance vessels could be caused by an elapsed ischemic episode. In studies by Simeone and Husni, 19 Sumner and Folse 20 and Wellington et al, 21 it was found that both edema and hyperemia occurred after successful peripheral revascularization. In these studies, wash-out of 133 Xenon was used as a flow indicator.…”

Section: Hyperemiamentioning

confidence: 97%

Pathophysiology and treatment of edema following femoropopliteal bypass surgery

Slaa

Dolmans

et al. 2012

Vascular

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“…After 4 hours of ischemia, hyperemia lasted from 3 to more than 6 weeks. In 102 of 104 simultaneous observations made 3 weeks after 4, 6, or 8-hour occlusions, the flow in the post-ischemic leg significantly exceeded that in the normal leg.…”

Section: Animal Experiments Materials and Methodsmentioning

confidence: 99%

Persistent Hyperemia Following Prolonged Arterial Occlusion

Sumner

Folse

1968

Annals of Surgery

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Muscle Blood-Flow Following Insertion of a By-pass Vein-Graft in Femoropopliteal Occlusive Disease

Bell

Short

1972

Journal of British Surgery

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Muscle blood‐flow has been measured by the local clearance of 133Xe in 32 patients (34 limbs) following arterial replacement with a by‐pass vein‐graft for atherosclerotic occlusive disease affecting the femoropopliteal segment. In 27 cases (29 limbs) in which the graft was functioning satisfactorily there was a marked improvement in muscle blood‐flow with a return to within normal range in most instances. In 5 patients the graft occluded within 3 months of operation and in these cases there was no significant alteration in the muscle blood‐flow following operation. The measurement of muscle blood‐flow therefore provided objective corroborative evidence of the success or failure of the procedure. Seventeen of the group had muscle blood‐flow measurements carried out at 3‐monthly intervals for a year or more after operation. The postoperative flow tended to remain stable throughout this period, and did not show any tendency to return to the preoperative levels as has previously been reported for thrombo‐endarterectomy. This lends further support for the view that in reconstructive surgery for femoropopliteal occlusive disease the long‐term results are better with by‐pass vein‐grafts than with thrombo‐endarterectomy.

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Hyperaemia of the calf after arterial reconstruction for atherosclerotic occlusion. A plethysmographic study

Cited by 13 publications

References 4 publications

Pathophysiology and treatment of edema following femoropopliteal bypass surgery

Pathophysiology and treatment of edema following femoropopliteal bypass surgery

Persistent Hyperemia Following Prolonged Arterial Occlusion

Muscle Blood-Flow Following Insertion of a By-pass Vein-Graft in Femoropopliteal Occlusive Disease

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