Pneumatic tourniquet as a substitute for vascular clamps in distal bypass surgery.

The pneumatic tourniquet is an effective substitute for vascular clamps in tibial and popliteal artery surgery. Intimal trauma due to clamping is avoided. Because circumferential dissection of the vessel is not necessary, the vasa vasorum are preserved minimizing ischemic injury to the vessel wall. The technique has been employed in 40 distal popliteal and tibial reconsteal and tibial reconstructions during the past year with only one complication that may possibly be related to its use. Early patency was 92% at the patient's time of discharge from the hospital. In all four patients requiring below-knee amputation, primary wound healing and successful prosthetic rehabilitation were achieved. This technique appears to be safe and simplifies distal reconstructions for lower extremity ischemia.