Crossover Left Common Femoral to Right Superficial Femoral Artery Bypass Graft Using a Lateral Approach

Abstract

Background: A 62-year-old man presented in April 2019 for right lower extremity pain and paresthesia. The pain progressed to ischemic rest pain in October 2019 with an ankle-brachial index of 0.34 on the right lower extremity. Arteriography showed right external iliac artery and common femoral artery occlusions with anterior tibial artery run-off. Because of severe scarring from the patient's previous vascular reconstructions and major trauma, it was decided that a conventional approach may result in surgical site infection and exposure of the graft. In this video, we demonstrate a lateral approach for exposure of the superficial femoral artery in order to perform femoral anastomosis of the crossover femoral graft.