Extended extraanatomic arterial reconstruction: subclavian artery-bifemoro-crossover-popliteo-tibial-PTFE-bypass.
In a high risk patient an extended extraanatomic PTFE (ring armored) bypass was performed for limb salvage. The right subclavian artery served as donor vessel to the left tibial anterior artery in a crossover suprapubic fashion. A total of 7 anastomoses in this subclavian bifemoro-crossover popliteo-crural reconstruction yielded a high flow situation as well as good function with a palpable dorsalis pedis artery pulse and a postoperatively increased ankle-brachial pressure index of 0.9, 8 months postoperatively. During the 9th postoperative month the distal part of the reconstruction occluded and the left leg was amputated below the knee. However, limb salvage was achieved for 9 months. Several points are discussed in connection with long-term functioning.
D001161:Arteriosclerosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005263:Femoral Artery / Q000601:surgery; D005734:Gangrene / Q000150:complications; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D007866:Leg / Q000098:blood supply*; D008297:Male; D008722:Methods; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D013348:Subclavian Artery / Q000601:surgery