Secondary Bypass after Infrainguinal Bypass Graft Failure

Patients who suffer failure of a previous infrainguinal bypass graft often present with recurrent ischemia requiring secondary revascularization for limb salvage. These patients pose major challenges for the vascular surgeon. Management strategies vary with the time interval from bypass, the functional status of the patient, the degree of ischemia and the availability of autogenous vein. This article reviews the treatment options for these difficult patients and the results which can be achieved.