Abstract

Objectives: Composite sequential arterial bypass is a useful option for treatment of peripheral vascular disease when autologous vein is limited. We have described a modified technique for composite sequential bypass using an extended polytetrafluoroethylene (ePTFE) synthetic graft and the long saphenous vein. These are linked via a common intermediate section anastomosed to the native vessel arteriotomy in a diamond configuration (diamond anastomosis). Methods: The diamond composite sequential bypass procedure was performed on six patients to treat critical limb ischemia (gangrene, ischemic ulceration, severe rest pain). The proximal bypass grafts consist of ePTFE, to

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