What a great disappointment to find that the graft you put yesterday to treat a patient with lower limb ischemia has been blocked!!! Did you spend 2, 3 even 4 hours for nothing? You need to re-explore the patient, especially if he/she develops acute limb ischemia. Should you take him/her straight to the theater ? Or what else should you do in this unpleasant situation?
A graft is occluded straight after its insertion for technical issue(s):
- Problematic inflow
- Problematic outflow
- Bad anastomosis
- Graft of poor quality
- Hypercoagulopathy (???)
So what do you need to do carry on? Definitely, before taking the patient to the theatre, take a deep breath and ask for a CT angiogram. It will give you an idea of what went wrong the first time and what you can try to get it better this time
(To be continued…)