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Plastic Surgery and Modern Techniques

Ischemia of foot is not a rare problem and is found in diabetes, atherosclerosis and Buerger’s disease. Many a times if ischemia is not treated properly it may progress to gangrene requiring amputation of foot [1]. There are various modalitites of treatment which are effective like arterial bypass and angioplasty [2] and stem cell transplantation1. Arterial bypass is effective if there is occlusion of short or long segments of vessels but terminal arterial tree is free of occlusion which is not the case in most of the patients of diabetes and atherosclerosis. Angioplasty is also effective in short segment occlusion and not very effective in terminal arterial tree blockage. There is no report of stem cell transplantation in such patients. There are reports of stem cell transplantation in muscles in leg ischemia but not in distal vessel disease. For such patients who have blockage of distal arterial tree we have developed the technique of creation of A V fistula between patent artery and venous system to increase the blood supply of distal foot We did the procedure in 21 patients over a period of five years and archived good results.