Page 48 - Virtual Vascular Vol 9

Multiple attempts were made to pass a guidewire to cross the occlusion, but to no avail as In view of persistent tissue loss, revascularization in the form of femoropopliteal bypass was
the occlusion was very calcified, typical of renal and diabetic patients. Without crossing performed using a 7mm ringed PTFE graft. The femoral artery was exposed using the
the target lesion, endovascular procedures such as angioplasty or stenting was not longitudinal incision in the groin, and the above-knee popliteal artery exposed through a

possible. standard medial approach. The synthetic graft was passed through a tunneler.

Proximal end of the sub-sartorial tunnel with the tunneler in situ next to the
femoral artery (arrowed).

Guidewire cannot
pass through the

occlusion (target Sartorial muscle

lesion).

Distal end of the sub-sartorial tunnel with the tunneler in situ next to the above

48 knee (suprageniculate) popliteal artery (yellow arrow). 49