Infrainguinal bypass of previously amputated limbs

Below-knee amputation (BKA) is a patient's best chance at regaining ambulatory status when limb salvage is impossible. Unfortunately, up to 20% of BKAs require revision to a higher level, most commonly due to poor stump perfusion. Although inflow procedures are relatively common both before and shortly after BKA, there are no prior reports describing surgical revascularization of a previously intact BKA stump that develops chronic ischemia due to femoral-popliteal occlusive disease. This case series of four revascularized BKA stumps in three patients demonstrates that infrainguinal bypass should be considered before conversion to an above-knee amputation.