[Hybrid infrainguinal revascularization for critical limb ischemia]

The introduction of endovascular procedures in the routine of vascular surgery allowed for the expansion of therapeutic options in the diverse areas of vascular disease. Endoluminal revascularization can be regarded as a usefull complement of conventional surgical techniques. An above-knee femoro-popliteal bypass surgery ePTFE graft has been performed, followed by a sheath introduction on the graft body. This allows a simplified access to crural vessels, while providing efficient revascularization of the femoro-popliteal sector. Distal revascularization was performed using angioplasty and stenting when appropriate, as to insure continuous flux in at least one of the tibial or the peroneal arteries. The aim of this kind of procedure is to insure efficient femoro-popliteal revascularization and to achieve a run-off to the foot in at least one vessel. This type of intervention may be particularly attractive in Leriche-Fontaine's grade IV patients with no available autologous venous graft.