Creation of an Arterialized Cephalic Vein as Autologous Bypass for Below-Knee Reconstruction in Critical Limb Ischemia

Two cases of below-knee bypasses using an arterialized cephalic vein (CV) are presented. Both patients had critical ischemia, but no greater or lesser saphenous veins (LSVs) were usable. According to ultrasound, the CVs were thin but regularly positioned. Four weeks after wrist fistula was created, ultrasound showed adequate maturation, and the bypass operations were performed. Both patients had uneventful courses and were discharged after a few days with patent bypasses since then (35 and 18 months). As this report shows, creation of a fistula can be a useful option to gain autologous bypass material in case of critical limb ischemia.