Challenging the Endovascular Era: Open Bypass from Distal SFA to PTA Using Ipsilateral Reversed Saphenous Vein for Critical Limb Ischemia

Authors

Suraj Pai, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, IndiaFollow
Suresh Pai, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
Sanya Mukhida, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India
Aditya Nair, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India

Abstract

Open surgical revascularization remains a vital option in select patients with critical limb ischemia (CLI), especially when endovascular interventions are not feasible. We present a case of a 69 -year-old diabetic male with Rutherford class 5 CLI, initially planned for above-knee amputation due to extensive arterial occlusion and severe rest pain. The disease was attributed to his very significant smoking history which was stopped only recently. His CT Angiogram study revealed occlusion of distal superficial femoral artery with suboptimal distal reformation. Given the absence of endovascular options, he underwent successful open bypass from the distal superficial femoral artery (SFA) to the posterior tibial artery (PTA) using ipsilateral reversed great saphenous vein (GSV). The procedure, performed under regional anesthesia, resulted in excellent limb salvage with restoration of distal perfusion. This case highlights the ongoing relevance of open bypass in complex infrainguinal arterial disease

Recommended Citation

Pai, Suraj; Pai, Suresh; Mukhida, Sanya; and Nair, Aditya (2023) "Challenging the Endovascular Era: Open Bypass from Distal SFA to PTA Using Ipsilateral Reversed Saphenous Vein for Critical Limb Ischemia," Manipal Journal of Medical Sciences: Vol. 8: Iss. 2, Article 2.
DOI: https://doi.org/10.55889/2582-5984.1168
Available at: https://impressions.manipal.edu/mjms/vol8/iss2/2