Australia & New Zealand Society of Vascular Surgeons

Introduction Limb sparing, wide local excision is the recommended treatment for soft tissue and bone sarcomas. This presents a significant challenge to the vascular surgeon. We present four cases where amputation has been avoided. Methods Four patients 3 men and one woman aged between 15 – 76yrs presented with either an osteosarcoma of distal femur, recurrent popliteal synovial chondromatosis, recurrent Schwannoma of tibial nerve or leiomyosarcoma of the common femoral vein. In all cases the tumour was widely resected including popliteal artery and vein in 3 cases and femoral artery and vein in 1 case. Three cases also required resection of the knee joint, one case included the whole of the femur. The arterial repair was with reversed long saphenous vein from the contralateral leg, the venous repair using a panelled vein graft with an arterio-venous fistula. Results Follow up ranges from 1 month to 8 months. To date all patients have avoided amputation with functioning grafts. One case has required subsequent angioplasty of the superficial femoral artery proximal to the proximal anastomosis. Conclusion The treatment of these tumours requires multimodal therapy, with challenging reconstruction, the longer term results of this radical surgery are awaited.