Pedal bypass surgery is a highly demanding procedure with a strong possibility of instant failure and graft thrombosis. Stick adhesion to details may be useful for a favourite outcome. There follow some of my thoughts describing the way to go. Follow these steps and be a winner.
Tips
- Vein graft of good quality (diameter > 3 mm)
- Non-reversed graft configuration
- Careful valvulotomy (maximum 2 passages)
- Superficial route of the graft (personal preference the ScanlanTM tunneller)
- Distal anastomosis without clamps
- Parachute technique for the anastomoses
Necessities
- Magnification (at least 3.5x)
- Head lighting
- Small instruments (Castro needle holder, ring forceps)