Related Experiment Video
Updated: Jul 31, 2025

Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts
Published on: October 20, 2023
Posterior Approach to the Popliteal to Peroneal Bypass
Sigrid L Williamson1,2, Bernice Yu1,2, Robert Luo1,2
1Department of Surgery, Tower Health Reading Hospital, Reading, PA, USA.
Insights
Critical limb ischemia (CLI), a severe peripheral artery disease (PAD) complication, necessitates revascularization to prevent amputation. A posterior surgical approach for distal bypass grafting in CLI patients offers excellent exposure for limb salvage.
Area of Science:
- Vascular Surgery
- Peripheral Artery Disease Research
- Limb Salvage Procedures
Background:
- Critical limb ischemia (CLI) is a severe manifestation of peripheral artery disease (PAD), characterized by ischemic rest pain or tissue loss.
- CLI poses a significant risk of major limb amputation (30-50% within 1 year) without timely revascularization.
- Surgical revascularization is indicated for CLI patients with a life expectancy exceeding 2 years.
Abstract:
Critical limb ischemia (CLI) is a clinical syndrome related to peripheral artery disease (PAD) that is marked by ischemic rest pain or tissue loss such as nonhealing ulcers or gangrene. Without revascularization CLI carries a 30-50% risk of major limb amputation within 1 year. Initial surgical revascularization is recommended for patients with CLI who have a greater than 2-year life expectancy. We present the case of a 92-year-old male with severe peripheral artery disease with gangrene of bilateral toes who underwent right popliteal to distal peroneal bypass via the posterior approach using ipsilateral reversed GSV. The posterior approach provides excellent exposure and should be considered in distal surgical revascularization where the popliteal artery serves as inflow and distal peroneal artery as target outflow vessel.
Related Concept Videos
Arteries of Lower Limbs
Veins of Lower Limbs
Formed by the union of the medial and lateral plantar veins, the posterior tibial vein, rising through the calf muscle, assimilates the fibular vein. The anterior tibial vein, a superior extension of the foot's dorsalis pedis vein, merges with the posterior tibial vein at the...
Muscles of the Leg that Move the Foot and Toes
Anterior Compartment
The anterior compartment includes muscles that contribute to the dorsiflexion of the foot. This compartment houses the tibialis anterior, extensor hallucis longus, and extensor digitorum longus muscles....
Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Peripheral Artery Disease V: Postoperative Nursing Management
Pulse Assessment Sites

