The tourniquet as a routine adjunct in lower limb revascularization.

The use of a tourniquet as an adjunct for lower limb revascularization is safe, effective and improves visualization of the operative field. Less dissection of the target vessels is required and combined with non-use 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 also exists that early failure may be prevented by avoiding application of traumatic forces to diseased and brittle or calcified arteries. Although tourniquet time may have no impact on overall operative procedural time, certain phases of the operation are clearly shortened and facilitated, particularly in complex and difficult reconstructions. Histochemical changes in muscle biopsies do not adversely impact on patients in a clinical sense, but further investigation is required to elucidate subcellular events.