Contemporary use of fibula resection compared to traditional medial approach in peroneal artery bypass

Traditionally, approach to the peroneal artery for lower extremity bypass is performed from the medial calf (MED), where the artery's depth may limit access to mid/distal segments. Lateral resection of the fibula (FR) offers an alternate approach, albeit one less often utilized. In this single-center retrospective cohort study of 56 patients undergoing peroneal artery bypass, use of FR (n = 13) demonstrated similar outcomes to MED (n = 43), with 1-year primary patency 45.5% vs 38.5% (P = .736), respectively. Of note, FR was more likely than MED to have higher body mass index (P = .015). Contemporary use of fibula resection is an adjunct for lower extremity bypass.