Crural bypass as reoperation

: A retrospective study of 93 patients who have had repeat surgery at the tibial level for critical limb ischemia was carried out. In 21 patients a pseudoocclusion with a patent bypass graft was diagnosed and treated by PTA, thrombendarterectomy, or distal extension of the graft. The 5-year bypass patency was 60%, compared to 38% in those 72 patients that required a new bypass at the tibial level. Vein bypasses were better than prosthetic grafts. The number of previous operations did not negatively influence the outcome. However, the distal anastomosis should be placed on an artery that was not previously thrombectomized or operated on.