Tapered reinforced graft and vein cuff in the distal anastomosis as adjunct strategies for infrapopliteal prosthetic bypass graft in chronic limb-threatening ischemia: A case report

The great saphenous vein is the optimal conduit for infrapopliteal bypass surgery in chronic limb-threatening ischemia. A prosthetic bypass graft is an acceptable option when the autologous vein is unavailable and the anatomy is not favorable for endovascular therapy. However, the low patency rate of prosthetic grafts calls for adjunct strategies to improve the outcomes. Tapered reinforced grafts and vein cuffs are proposed measures. We herein present a case of a 78-year-old man with chronic limb-threatening ischemia and an extensive necrotic lesion on the dorsum of the left foot. He was successfully treated with a prosthetic bypass using two adjunct strategies to help improve patency: a tapered reinforced graft and a vein cuff in the distal anastomosis. After debridement and partial skin grafting, the wound healed completely in 2 months. The bypass graft was patent for 1 year.