Hemodynamics in arterial reconstructions of the lower limb. I. blood flow.

In order to establish normal and critical rates for peroperative, arterial blood flow, measurements were performed on 230 ileo-femoro-popliteal arteries subjected to reconstruction for atherosclerosis. Mean, basal blood flow after reconstruction was 134, 254 and 372 ml/min in the s. femoral, c. femoral and c. iliac arteries in vessels remaing open. These flow rates increased to a maximum of 375, 822 and 975 ml/min after intra-arterial injection of 40 mg papaverine. Flow rates were significantly lower in operations followed by early failure. In successfully reconstructed arteries, the mean, basal flow was restored to normal, but flow amplitude was still reduced, diastolic backflow was rarely seen and the flow-response to intra-arterial papaverine was significantly less than in normal arteries. Critical flow rates could not be defined but the frequency of primary failure increased significantly when basal blood flow after reconstruction was less than 100 ml/min or the papaverine induced flow was less than 200 ml/min. Preoperative blood flow was found to correlate well with the primary results of the operation while correlation with late results was less evident.