One-Year Follow-Up of an Inframalleolar Collateral Artery Bypass

Successful revascularization and restoration of blood flow to one of the pedal arteries is the mainstay to prevent major limb amputation. Here, we report a rare case of successful bypass to the inframalleolar ankle collateral artery in a middle-aged female with rheumatoid arthritis presenting with gangrene of the toes of the left foot. A computed tomography angiography (CTA) demonstrated normal infrarenal aorta, common iliac, external iliac, and common femoral arteries on the left side. The left superficial femoral, popliteal, tibial, and peroneal arteries were occluded. Extensive collateralization was noted in the left thigh and leg, with distal reformation in large ankle collateral. A successful bypass was done using from the common femoral artery to the ankle collateral using the great saphenous vein harvested from the same limb. At a one-year follow-up, the patient was symptom-free, and a CTA showed a patent bypass graft.