A surgical strategy for femoro-crural reconstruction

In order to improve the results of femoro-distal bypass grafting a number of tactics are suggested. The bypass distance should be kept to a minimum using autologous vein as a bridge between open segments. Anastomoses should be end to end wherever possible because of their haemodynamic characteristics and collaterals should be preserved by a proximal end to side anastomosis. When salvaging the extremity the dissection should be kept to a minimum in tissue which is already ischaemic.