Bypass to the Popliteal Artery

  • Hisham Rashid


A case of recurrent leg claudication in a fit young woman after a failed femero-popliteal bypass. The patient suffered from increasing severe short distance claudication in her left calf that has affected her life style and ability to carry on her job duties. Medical treatment and regular exercise has failed to improve her walking distance. The patient has accepted the risks of undergoing redo bypass surgery using synthetic graft due to absence of suitable venous conduit.


  1. 1.
    van den Houten MM, Lauret GJ, Fakhry F, Fokkenrood HJ, van Asselt AD, Hunink MG, Teijink JA. Cost-effectiveness of supervised exercise therapy compared with endovascular revascularization for intermittent claudication. Br J Surg. 2016;103(12):1616–25.CrossRefPubMedGoogle Scholar
  2. 2.
    Bedenis R, Stewart M, Cleanthis M, Robless P, Mikhailidis DP, Stansby G. Cilostazol for intermittent claudication. Cochrane Database Syst Rev. 2014;10:CD003748.Google Scholar
  3. 3.
    de Vos MS, Hawkins AT, Hevelone ND, Hamming JF, Nguyen LL. National variation in the utilization of alternative imaging in peripheral arterial disease. J Vasc Surg. 2014;59(5):1315–22.CrossRefPubMedGoogle Scholar
  4. 4.
    Luján S, Criado E, Puras E, Izquierdo LM. Duplex scanning or arteriography for preoperative planning of lower limb revascularisation. Eur J Vasc Endovasc Surg. 2002;24(1):31–6.CrossRefPubMedGoogle Scholar
  5. 5.
    TASC Steering Committee, Jaff MR, White CJ, Hiatt WR, Fowkes GR, Dormandy J, Razavi M, Reekers J, Norgren L. An update on methods for revascularization and expansion of the TASC lesion classification to include below-the-knee arteries: a supplement to the inter-society consensus for the management of peripheral arterial disease (TASC II). Vasc Med. 2015;20(5):465–78.CrossRefGoogle Scholar
  6. 6.
    Panneton JM, Hollier LH, Hofer JM. Multicenter randomized prospective trial comparing a pre-cuffed polytetrafluoroethylene graft to vein cuffed polytetrafluoroethylene graft for infra-genicular arterial bypass. Ann Vasc Surg. 2004;18(2):199–206.CrossRefPubMedGoogle Scholar
  7. 7.
    Stonebridge PA, Prescott RJ, Ruckley CV. Randomized trial comparing infrainguinal polytetrafluoroethylene bypass grafting with and without vein interposition cuff at the distal anastomosis. The Joint Vascular Research Group. J Vasc Surg. 1997;26(4):543–50.CrossRefPubMedGoogle Scholar
  8. 8.
    SCAMICOS, Lundgren F, Bergquist D, Norgren L, Schroeder T, Carstensen J, Hälsa T, Almstrom C, Almgren B, Drott C, Jansson I, Hallstensson S, Jivegard L, Ortenwall P, Tuvesson T, Plate G, Potemkowski A, Lundqvist B, Emtersjo G, Jonsson B, Jonung T, Lindblad B, Almstrom C, Wingren U, Svensson M, Fornander B, Bjorck M, Brunes L, Johansson G, Karlstrom L, Tornell PE, Ljungman C, Aldman A, Forsberg O, Bjorkman H, Arfvidsson B, Bohlin T, Nielsen JS, Schroeder T, Madsen M. PTFE bypass to below-knee arteries: distal vein collar or not? A prospective randomised multicentre study. Eur J Vasc Endovasc Surg. 2010;39(6):747–54.CrossRefGoogle Scholar
  9. 9.
    SCAMICOS, Lundgren F, Bergquist D, Norgren L, Schroeder T, Almström C, Almgren B, Drott C, Jansson I, Hallstensson S, Jivegård L, Ortenwall P, Tuvesson T, Plate G, Potemkowski A, Lundqvist B, Emtersjö G, Jönsson B, Jonung T, Lindblad B, Almström C, Wingren U, Svensson M, Fornander B, Björck M, Brunes L, Johansson G, Karlström L, Tornell PE, Ljungmann C, Aldman A, Forsberg O, Björkman H, Arfvidsson B, Bohlin T, Sloth Nielsen J, Schroeder T, Stahl Madsen M. Does patency after a vein collar and PTFE-bypass depend on sex and age? Re-analysis of a randomised trial. Int Angiol. 2012;31(2):156–62.Google Scholar
  10. 10.
    Green RM, Abbott WM, Matsumoto T, et al. Prosthetic above-knee femoropopliteal bypass grafting: five-year results of a randomized trial. J Vasc Surg. 2000;31:417–25.CrossRefPubMedGoogle Scholar
  11. 11.
    Pappas PJ, Hobson RW, Meyers MG, et al. Patency of infrainguinal polyte-trafluoroethylene bypass grafts with distal interposition vein cuffs. Cardiovasc Surg. 1998;6:19–26.CrossRefPubMedGoogle Scholar
  12. 12.
    Taylor RS, Loh A, RJ MF, Cox M, Chester JF. Improved technique for polytetrafluoroethylene bypass grafting: long-term results using anastomotic vein patches. Br J Surg. 1992;79:348–54.CrossRefPubMedGoogle Scholar
  13. 13.
    Lindholt JS, Houlind K, Gottschalksen B, Pedersen CN, Ravn H, Viddal B, Pedersen G, Rasmussen M, Wedel C, Bramsen MB. Five-year outcomes following a randomized trial of femorofemoral and femoropopliteal bypass grafting with heparin-bonded or standard polytetrafluoroethylene grafts. Br J Surg. 2016;103(10):1300–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Arvela E, Söderström M, Albäck A, Aho PS, Venermo M, Lepäntalo M. Arm vein conduit vs prosthetic graft in infrainguinal revascularization for critical leg ischemia. J Vasc Surg. 2010;52(3):616–23.CrossRefPubMedGoogle Scholar
  15. 15.
    Geraghty AJ, Welch K. Antithrombotic agents for preventing thrombosis after infrainguinal arterial bypass surgery. Cochrane Database Syst Rev. 2011;6:CD000536.Google Scholar
  16. 16.
    Bandyk DF, Cato RF, Towne JB. A low flow velocity predicts failure of femoropopliteal and femorotibial bypass grafts. Surgery. 1985;98(4):799–809.PubMedGoogle Scholar
  17. 17.
    Davies AH, Hawdon AJ, Sydes MR, Thompson SG, VGST Participants. Is duplex surveillance of value after leg vein bypass grafting? Principal results of the Vein Graft Surveillance Randomised Trial (VGST). Circulation. 2005;112(13):1985–91.CrossRefPubMedGoogle Scholar
  18. 18.
    Bill S. Majdalany, Frank J. Rybicki, Karin E. Dill, Dennis F. Bandyk, Christopher J. Francois, Marie D. Gerhard-Herman, Michael Hanley, Sanjeeva P. Kalva, Emile R. Mohler III, John M. Moriarty, Isabel B. Oliva, Matthew P. Schenker, Clifford Weiss. Follow-up of lower extremity arterial bypass surgery. Expert Panel on Vascular Imaging: American College of Radiology ACR Appropriateness Criteria. bypass-surgery/#section-442.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.King’s College HospitalLondonUK

Personalised recommendations