ABSTRACT
Occlusive vascular disease may involve the common femoral artery, as well as distal branches, above-the-knee (AK) and below-the-knee (BK) popliteal, and anterior tibial and posterior tibial, peroneal vessels or their branches. The involvement can begin at any time in one’s adult life and move forward, produce flow-reducing narrowing, and finally, occlusion. The atherosclerotic involvement, one identifies in the lower extremity, is also manifest in other parts of the body; atherosclerosis is a multivessel process. This diffuse involvement may modify or mitigate the surgeon’s attempts at maintaining function. The focus is often an isolated extremity, but an assessment of the risk–benefit analysis of any intervention must be undertaken. Active intervention is based on disability, threat to limb loss, or interference of normal daily function. Therefore, the indication for surgical intervention may be claudication if it interferes with the patient’s lifestyle. A wound, unresponsive to conservative management, with rest pain or tissue breakdown, more likely than not, will require reconstructive vascular surgery (1,2).
