A Limb Saving, Intra-medullary Crural Bypass

Abstract

Routing a bypass through a bony structure in a transverse direction during femorodistal bypass procedures has been previously reported. This paper describes a patient who needed a crural revascularisation, but a normal passage through a deep or superficial route was not possible because of the circumferential ossification of the lower left leg muscles as a result of trauma 7 years earlier. The long saphenous vein in the left leg had been used for an earlier reconstruction, ruling out an in-situ graft. A limb saving bypass to the distal posterior tibial artery was performed through an intra-medullary tibial route.