Amputation prevention: experience in bypass surgery

Introduction: The development of chronic peripheral arteriopathy in the infrapatellar axis is closely related to diabetes. The disease's most advanced stages are a frequent reason for consultation and hospitalization, generally due to unhealed lesions of long evolution. In many cases, the need to revascularize the axis is crucial to prevent its progression and improve its evolution. Failure to act in the resolution may lead to the compromise of the limb up to its loss. Objective: To disseminate a surgical team's experience using infrapatellar bypass as a valuable resource in preventing amputations due to ischemia. Material and methods: A retrospective study of 87 infrapatellar revascularizations by the same surgical team from April 2023 to June 2024, with venous bypass as the revascularization method. Results: The most frequent complication after the procedure was wound dehiscence (28%); major amputation was observed in approximately 6%. Of the sample, 89 % (78 patients) maintained the bypass permeable at 3 months. Of the remaining patients, 5 underwent amputation, and 4 had thrombosis within the first 10 days. Conclusion: Infrapatellar bypass has proven to be an effective revascularization option. It can improve the quality of life and survival rate by avoiding serious complications associated with ischemia.