Comparable Limb Salvage Outcomes on Pop Distal Bypass when Using Plantar Artery as a Distal Target

Area of Science:

• Vascular Surgery
• Reconstructive Surgery
• Peripheral Artery Disease

Background:

• Infragenicular bypass is crucial for limb salvage in patients with peripheral artery disease.
• The plantar artery is an underutilized distal target for bypass surgery.
• Evaluating plantar artery bypass outcomes is essential for optimizing treatment strategies.

Purpose of the Study:

• To assess limb salvage and patency rates of infragenicular bypasses targeting the plantar artery.
• To compare outcomes of plantar artery bypasses with those to other tibial arteries.

Main Methods:

• Retrospective cohort study of 90 infragenicular bypass procedures using autologous venous conduits (July 2012-June 2018).
• Data collected included demographics, surgical indications, limb salvage, and bypass patency.
• Exclusion criteria: inflow above the knee, acute limb ischemia, synthetic conduits.

Main Results:

• The study included 90 bypasses to various tibial and plantar arteries, with a median follow-up of 65 months.
• One-year limb salvage was 65% for plantar artery bypasses versus 82% for other tibial arteries.
• One-year patency was 65% for plantar bypasses and 82% for others, dropping to 60% and 75% at 3 years, respectively.

Conclusions:

• The plantar artery is an effective target for infragenicular bypass with autologous vein grafts.
• Acceptable limb salvage and patency rates support its use in selected patients.
• Outcomes are comparable to bypasses targeting other tibial arteries.