75 year old male, prior right leg bypass graft from the common femoral artery to the anterior tibial artery. Bypass graft failed due to poor outflow in the anterior tibial artery. During thrombolysis the patient had a large retroperitoneal bleed. Treatment was stopped and the patient was told there were no other options. The patient came with rest pain at night, digital ulcerations, and 15 foot claudication. An initial attempt using a traditional approach to recanalization of the superficial femoral and poplieteal arteries failed. A second attempt at revascularization using the femoral and popliteal veins as a route to create a percutaneous bypass graft from the common femoral artery to the popliteal artery was successful.
65 year old cyclist with extensive superficial and deep venous incompetence and venous ulceration
83 year old developed non healing ulcer left foot after occlusion of a known popliteal artery aneursym
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.