Vascular

Femoropopliteal Bypass Graft

FEMOROPOPLITEAL BYPASS GRAFT

Indication: Superficial femoral artery (SFA) occlusion causing rest pain, tissue loss, or incapacitating claudication failing conservative management. Above-knee popliteal: vein or PTFE graft with comparable early results. Below-knee popliteal: autologous vein strongly preferred (inferior patency with prosthetic graft below the knee).

Patient Position: Supine, ipsilateral leg slightly flexed and externally rotated.

Anaesthesia: General, regional, or local with sedation.

Incision: Vertical groin incision over the common femoral artery. Medial above-knee or below-knee thigh/leg incision to expose the popliteal artery. Additional incisions for saphenous vein harvest if in situ technique not used.

Procedure:
1. Common femoral artery exposed in the groin (inflow artery). Popliteal artery exposed in the appropriate segment (above or below the knee).