Peroneal-plantar artery bypass: a prone approach.
The potential space behind the distal tibia and ventral to the Achilles' tendon provides a route for bypass grafts to the plantar artery. Grafts may follow the communicating branch of the distal peroneal artery to reach the medial aspect of the foot. A prone approach for distal bypasses from the peroneal artery may facilitate exposure, conserve scarce venous conduit, and avoid scarred or infected sites. This peroneal-plantar bypass route has not been described previously. This technique was successfully used in a patient with diabetes mellitus, recurrent foot ischemia, infection, and limited venous conduit after a failed femorotibial bypass.
Best
Irwin M
IM
Department of Surgery, Morehouse School of Medicine, Atlanta, Ga. 30310-1495, USA. Besti@msm.edu
D000792:Angiography; D001158:Arteries / Q000601:surgery; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging; D017719:Diabetic Foot / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D005528:Foot / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014656:Vascular Surgical Procedures / Q000379:methods*