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Updated: Aug 12, 2026
Methods for Acute and Subacute Murine Hindlimb Ischemia
Published on: June 21, 2016
Bypass to the genicular arteries for revascularisation of the lower limb
F C Brochado Neto1, J Gonzalez, M Cinelli
1Vascular Surgery Section, Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, Brazil.
Insights
Infrainguinal bypass grafts to the genicular artery offer a viable option for limb salvage in patients with chronic limb ischemia. This technique achieved a 73% graft patency and successful limb salvage in most patients.
Area of Science:
- Vascular Surgery
- Arterial Reconstruction
- Limb Ischemia Treatment
Background:
- Chronic limb ischemia (CLI) poses a significant challenge, often necessitating complex surgical interventions.
- Femoropopliteal occlusive disease can limit traditional infrainguinal bypass targets.
- Genicular arteries represent potential distal targets for arterial reconstruction.
Purpose of the Study:
- To evaluate the initial experience and outcomes of infrainguinal bypass grafts placed distally into a genicular artery.
- To assess the feasibility and efficacy of genicular artery bypass for limb salvage in CLI patients.
Main Methods:
- Retrospective case series of eleven patients with Grade III CLI.
- Infrainguinal bypass grafts were performed using autologous vein segments.
- Grafts were directed to the descending genicular artery (n=4) or medial sural artery (n=6).
Main Results:
- Primary graft patency and limb salvage rates were 73% at 24 months.
- Patient survival was 100% at 1 month and 90% at 24 months.
- Seven of eight patients with patent grafts experienced ulcer healing or successful minor amputation site healing.
Conclusions:
- Distal genicular artery bypass is a valuable alternative for infrainguinal arterial reconstruction.
- This technique can extend the reconstructive options for limb salvage in CLI.
- Autologous vein bypass to genicular arteries offers potential long-term patient benefit.
Objective:
To describe an initial experience with infrainguinal bypass grafts inserted distally in a genicular artery.
Design:
Retrospective case series study.
Subjects And Methods:
Eleven patients with Grade III chronic limb ischaemia in whom arteriography showed femoropopliteal occlusive disease and at least one genicular branch suitable for receiving a bypass. Bypass grafts were done to the descending genicular artery (n=4) or the medial sural artery (n=6) using segments of autologous veins; one bypass was not completed.
Results:
Primary graft patency and foot salvage rates were 73% at 1 month and 24 months of follow-up. Patient survival rate was 100% and 90%, respectively. Major amputation was required in two of three patients following early graft failure. Of the eight patients who had a patent graft, the Doppler ankle-brachial systolic pressure index showed no change in one patient, an increase of 0.13-0.66 in six patients, and was not measured in one patient. The former patient underwent a below-knee amputation whereas the other seven patients showed complete healing of their skin ulcers and sites of minor amputation.
Conclusion:
The genicular bypass is a useful alternative that may extend the limits of infrainguinal arterial reconstruction with autologous tissue and the potential for long-term patient benefit.
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