2000
DOI: 10.1016/s0741-5214(00)90302-1
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The tourniquet revisited as an adjunct to lower limb revascularization

Abstract: The use of a tourniquet for lower limb revascularization is safe and effective and improves visualization of the operative field. Less dissection of the target vessels is required. With a combination of the nonuse of clamps and other occluding devices, we project a decrease in host hyperplastic response that will, in turn, impact favorably on patency rates. The possibility exists that early failure may be prevented by avoiding the application of traumatic forces to diseased and brittle or calcified arteries. I… Show more

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Cited by 11 publications
(12 citation statements)
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“…After application of the Esmarch bandage the anastomosis can easily be performed in a bloodless fi eld. This experience is confi rmed by previous reports from other authors who fi nd the use of a tourniquet very helpful in distal bypasses [26][27][28][29]. Our concept of surgical revascularization for TAO in selected cases is supported by a recent positive report from an Italian author describing a distal bypass in a case of extensive gangrene in a patient with TO [30].…”
Section: Discussionsupporting
confidence: 79%
“…After application of the Esmarch bandage the anastomosis can easily be performed in a bloodless fi eld. This experience is confi rmed by previous reports from other authors who fi nd the use of a tourniquet very helpful in distal bypasses [26][27][28][29]. Our concept of surgical revascularization for TAO in selected cases is supported by a recent positive report from an Italian author describing a distal bypass in a case of extensive gangrene in a patient with TO [30].…”
Section: Discussionsupporting
confidence: 79%
“…Additionally, a failure to obtain complete hemostasis with the use of a tourniquet was observed in 8% of cases in a series of 117 infrainguinal reconstruction procedures. 9 From the economical point of view, these devices have an initial increase of the procedural cost of about $1,650 US.…”
Section: Discussionmentioning
confidence: 99%
“…1e3 Other techniques for the creation of a blood-less field include the use of vessel loops, intra-arterial occlusion with balloons or shunts and tourniquet. 4 However, these techniques are also associated with risk of arterial damage, inadequate vascular occlusion and increased technical complexity of the anastomosis in the presence of intraarterial occlusion devices, as well as muscle and nerve damage in case of tourniquet. 3,5 A particular challenge is faced in distal bypass surgery in patients with unclampable calcified infra-popliteal vessels, which are more often present in the expanding cohort of vascular patients with diabetes and chronic renal failure.…”
mentioning
confidence: 99%