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. 2021 May;49(5):3000605211012607.
doi: 10.1177/03000605211012607.

Simultaneous femoro-popliteal artery bypass and foot free flap for lower limb salvage: a 13-year follow-up

Marius M Fodor  1 , Lucian Fodor  2
Affiliations

Simultaneous femoro-popliteal artery bypass and foot free flap for lower limb salvage: a 13-year follow-up

Marius M Fodor et al. J Int Med Res. 2021 May.

Abstract

Critical limb ischemia (CLI) associated with lower extremity complex wounds is challenging for vascular and plastic surgeons. Despite a high risk of perioperative morbidity, complex reconstructive surgery in these patients is an alternative to primary major limb amputation. We present a patient with CLI and a complex foot wound treated with simultaneous femoro-popliteal arterial bypass and free flap for lower limb salvage. The 13-year follow-up showed good functional results.

Keywords: Critical ischemia; bypass; complex lower extremity wound; free flap; limb salvage; reconstruction.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
The necrotic wound on the patient’s hindfoot on admission.
Figure 2.
Figure 2.
Femoro-popliteal arterial bypass. a. Femoro-popliteal arterial bypass with reversed vein conduit (arrow). b. The proximal anastomoses end to side to the prosthesis of the previous aorto-bifemoral arterial bypass. c. The distal anastomoses.
Figure 3.
Figure 3.
Free flap reconstruction. a. The split latissimus dorsi flap. b. Two weeks after surgery; notice the muscle mass. c. Three years after surgery; notice the shrinkage of the denervated muscle.
Figure 4.
Figure 4.
Computed tomography angiography (CTA) performed 13 years post-reconstruction. Note the permeability of the femoro-popliteal artery bypass (arrow 1) and the arterial microvascular anastomosis to the anterior tibial artery (arrow 2).
See this image and copyright information in PMC

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