[Simultaneous popliteal and leg revascularisation by sequential saphenous bypass in situ (author's transl)]

Certain types of threatening leg ischaemia are difficult to treat when there is a combination of obstruction at three levels: superficial femoral, popliteal and leg, leaving as the only distal vascular network a short segment of upper popliteal artery, "suspended" between several collaterals and a distal leg artery. Classical techniques come up against problems in terms of revascularisation ("suspended" popliteal or leg), surgical material and the flow rate in the graft. The technique suggested here uses the devalved great saphenous vein left in place to revascularise succesively, "sequentially", the 2 permeable arterial levels. The main advantages are the absence of any prosthesis, an increase in flow and improved haemodynamics of the arrangement, and the double level of revascularisation.