Distal bypass surgery using a donor vein from the first-line relative with delayed endovascular revascularization of the lower limb through a shunt

A combined treatment using a native donor small saphenous vein and endovascular method for repeated revascularization of the lower limb is described. Over the previous 2 years, the patient underwent 9 revascularizations of the right lower limb with short periods of arterial and graft patency. The patient underwent deep femoral artery-posterior tibial bypass surgery of the right lower limb with a donor vein from the first-line relative. Delayed endovascular revascularization of the lower leg and foot was performed due to distal stenoses of posterior and anterior tibial arteries to optimize outflow through the graft. After 5 months, the shunt is patent, and trophic defects healed.