A novel innovative technique in the management of bilateral critical limb ischaemia: delayed saphenous vein autologous graft

Ann R Coll Surg Engl. 2022 Jun;104(6):e177-e179. doi: 10.1308/rcsann.2021.0248. Epub 2022 Feb 9.

Abstract

A 31-year-old man with primary oxalosis and resultant polyneuropathy presented with worsening leg pain. He was found to have bilateral superficial femoral artery dissections with a non-viable left leg and critically ischaemic right leg. He underwent emergency left above-knee amputation with harvesting of the full-length ipsilateral great saphenous vein (GSV). In a novel technique, the vein was stored for 10 days before being used as conduit in a femoral-popliteal bypass in the contralateral leg. The success of the delayed GSV autograft means the salvage of clinically viable veins in non-viable limbs should be considered when patients present with bilateral acute or critically ischaemic limbs.

Keywords: Critical limb ischaemia; Delayed autograft; Emergency amputation; Vascular surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arterial Occlusive Diseases* / surgery
  • Chronic Limb-Threatening Ischemia
  • Humans
  • Ischemia / etiology
  • Ischemia / surgery
  • Leg / blood supply
  • Leg / surgery
  • Limb Salvage
  • Male
  • Peripheral Vascular Diseases*
  • Popliteal Artery / surgery
  • Retrospective Studies
  • Saphenous Vein / transplantation
  • Vascular Patency