The tourniquet revisited as an adjunct to lower limb revascularization

Abstract

The use of a tourniquet for lower limb revascularization is safe and effective and improves visualization of the operative field. Less dissection of the target vessels is required. With a combination of the nonuse of clamps and other occluding devices, we project a decrease in host hyperplastic response that will, in turn, impact favorably on patency rates. The possibility exists that early failure may be prevented by avoiding the application of traumatic forces to diseased and brittle or calcified arteries. In this study, tourniquet time had no impact on overall operative procedural time, although certain phases of the operation were clearly shortened and facilitated, particularly in complex and difficult reconstructions. Histochemical changes found in muscle biopsy specimens did not adversely impact patients clinically, but further investigation is required to elucidate subcellular events.

Tourniquet Use in Extremity-Based Microsurgery

“…17 Vascular anastomoses following tourniquet use have previously been investigated by Ciervo et al in lower limb revascularization, with results showing no differences in complication rates (thrombosis, vascular/nerve injury) between tourniquet versus no tourniquet groups. 18 However, the authors did find a significant decrease in dissection time with tourniquet use due to a bloodless operating field. Additional studies have investigated the use of a tourniquet as a substitute for vascular clamps in distal arterial bypasses, with lower long-term complication rates possibly due to a lack of vascular intimal damage.…”