Tibial Artery Bypass for Limb Salvage

Limb salvage with preservation of function is the goal of therapy in severe vascular insufficiency of the lower extremities. Attainment of this goal when disease is localized to the superficial femoral artery has been achieved in the majority of patients by femoral popliteal bypass grafting. Occasionally, patients are seen in whom the extent of occlusive involvement of the distal popliteal artery and its proximal branches limits the potential for success by this method. Delayed films taken during ateriography in these patients have frequently shown patency of the tibial and peroneal arteries in the lower leg. Tyson and DeLaurentis,¹McGaughan,²Dale,³Garrett et al,⁴Noon et al,⁵and Mannick and Hume⁶have reported revascularization in such patients by extending bypass grafts to these vessels; results of these reports indicate the feasibility of limb salvage by this approach. Recent experience with 22 patients undergoing a total