FIELD: medicine.
SUBSTANCE: distal anastomosis is formed behind the external ankle at the source of the small saphenous vein, the "end-to-side" type between the distal part of the reversed autovein and the small saphenous vein. Then autovein is inflated with warm saline solution with heparin. A shunt is performed subcutaneously over the fibula, on the anterolateral surface of the shin. Then the anterior artery is extracted through the longitudinal incision, it is opened longitudinally and an anastomosis is put in the side-to-side anastomosis between the auto veinous and anterior tibial artery. Then in the middle third, on the inner surface of the shin, access to the posterior tibia and peroneal arteries is formed. Perforate the interosseous membrane and withdraw the autoven on the inner surface of the tibia, and then gradually form an anastomosis "side-to-side" an autovenous shunt with the peroneal, then the posterior tibial arteries. The shunt is performed on the inner surface of the leg and thigh subcutaneously to the groin, and the proximal anastomosis is formed.
EFFECT: method allows to restore blood flow along the arteries of the shin, to keep the shunt working even with occlusion of all the arteries of the shin, to maintain blood flow of the foot, due to arterialization of the distal branches of the small saphenous vein.
2 ex
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Authors
Dates
2017-10-05—Published
2016-06-28—Filed