title: Popliteo-distal and tibio-tibial bypasses: a viable alternative for the revascularisation of the critically ischaemic limb.
abstract: BACKGROUND
  The aim of the present study was to evaluate graft patency and limb salvage rates of popliteo-distal and tibio-tibial bypasses performed for critical ischaemia of the lower limb.
  
  
  METHODS
  Thirty short bypasses performed during a five-year period (1994-1998) were reviewed. The inflow source was the supragenicular popliteal artery in 14 patients, the infragenicular popliteal artery in 12 patients and a tibial artery in four patients. Distal outflow was to a pedal vessel in 14 patients, and above the malleolus in 16 patients. Autogenous vein was used as conduit (saphenous vein in 28 patients and cephalic vein in two patients).
  
  
  RESULTS
  Operative mortality was 3.3%. Early graft patency and limb salvage rates were 90 and 93%, respectively. Late primary and secondary patency, and limb salvage rates were 77%, 80 and 76% at 12 months, and 71, 74 and 76% at 24 months, respectively. These rates showed no differences attributable to diabetes, inflow or outflow site, surgical technique or slight proximal involvement. There was no progression of disease in the superficial femoral artery, even in the presence of moderate preoperative lesions.
  
  
  CONCLUSIONS
  Popliteo-distal and tibio-tibial bypasses are durable procedures which yield good bypass patency and limb salvage rates.
authors.affiliation: Vascular Surgery, Hospital Universitario San Carlos, Universidad Complutense, Prof. Martín Lagos s/n, 28040 Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Moñux Ducajú
authors.forename: F J
authors.initials: FJ
authors.lastname: Serrano Hernando
authors.forename: L
authors.initials: L
authors.lastname: Sanchez Hervás
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D001158:Arteries / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D016009:Chi-Square Distribution; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D013977:Tibia; D016896:Treatment Outcome