Hybrid Leg Revascularization: Remote Endarterectomy and Deep Vein Bypass to Posterior Tibial Artery

Abstract

Early endovascular intervention for intermittent claudication is a common practice and is associated with progression to chronic limb-threatening ischemia and elevated amputation risk. When failure for this common approach ultimately occurs, the result is a complex arterial occlusive pattern. Coupled with absent autologous vein conduit, the risk of amputation for this patient profile is high. Remote endarterectomy with endovascular stent explant is a reliable technique to treat chronic total occlusion of the superficial femoral artery (SFA) and restore inflow.