We describe the case of a ruptured woven polyester common femoral-to-popliteal artery bypass graft, in which the lack of a suitable proximal landing zone precluded a totally endovascular approach to revascularization. The patient was treated with Viabahn endoprostheses (W. L. Gore & Associates, Flagstaff, Ariz), with the proximal end of the proximal Viabahn emerging from a graft arteriotomy and sutured directly end-to-side to the native common femoral artery. We believe this is the first reported case of a sutured anastomosis of the Viabahn endoprosthesis to a native vessel. The surgical technique is illustrated, and potential indications are discussed.
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