Prediction of distal reconstruction following aortofemoral bypass for limb salvage.

The predictive value of noninvasive Doppler arterial evaluation was assessed in 42 limbs before and after aortofemoral bypass for severe limb ischemia. The preoperative ankle-brachial systolic index was not of predictive value for the need of further distal reconstructin. A postoperative increase of ankle index by 0.1, or more, indicatd that, probably, no additional distal reconstruction would be necessary. Two-thirds of the limbs in which the ankle index did not improve by 0.1 required further distal bypass. Perioperative noninvasive arterial evaluation is helpful in supplementing clinical assessment and angiograpic data in the decision-making for, or against, distal bypass following aortofemoral bypass for limb salvage.