[Prosthetic revascularization of the midpopliteal artery through a posterior approach: a clinical experience]

Bypass grafting to the proximal or distal popliteal artery through a lateral approach is the most commum surgical technique used to treat patients with femoro-popliteal obstructive disease. We report all the patients who underwent a bypass graft to the midpopliteal artery through a posterior approach, in whom an autologous vein was not avalaiable, thus avoiding the use of a prosthetic graft implantation in to the infragenicular popliteal artery. Ten bypass grafts to the midpopliteal artery through a posterior approach were performed, for the last 6 years, in patients with critical limb ischaemia. Polytetrafluoroethylene ( PTFE ) grafts were used in all patients. With a mean follow-up of 16,1 months, the 1-year primary patency rate was 85,7 % and the 2-year primary patency rate was 66,7 %. Bypass grafting to the midpopliteal artery through a posterior approach seems to be a safe and sustainable procedure and is an alternative techinique to be considered in patients without autologus vein avalaiable, when an above-knee bypass grafting is not feasible or when a below-knee prothesis should be avoided.