Tourniquet occlusion technique for tibial artery reconstruction.

The pneumatic compression tourniquet for tibial artery reconstruction reduces the necessary dissection, decreasing the risk of arterial and venous injury. It provides effective control of side branches, often expedites the operation, and provides a bloodless operative field with elimination of the need for clamps or vessel loops and their risk of arterial injury. They are easy to use, readily available, and, when used after leg elevation and esmarch compression, very effective. Despite the theoretical risks of muscle injury, nerve damage, or reperfusion syndrome, complications are rare. Overall results with the tourniquet in all recent reports have been excellent, and it can greatly facilitate tibial artery bypass.