Objective
Critical limb ischemia can be seen as different clinics from amputation to life threatening problems. Endovascular and surgical techniques are performed for treatment. In femoral region anatomy changes and subcutaneous adherent tissue comes in sight due to recurrent surgical interventions and because of this reason endovascular technique may be difficult. A patient who has critical limb ischemia and endovascular treatment is hard for whom was aimed at treating by endovascular therapy via surgical exploration under local anesthesia.
Methods
In his past history he has had three times ipsilateral and once contralateral peripheral artery bypass surgeries. A 60-year old male patient that has critical limb ischemia was admitted to our clinic with his ischemic limb which bypass grafts are occluded and with its ischemic ulcer. Beside the recurrent peripheral bypass surgeries he has COPD, DM and coronary artery disease. And with these diseases he has been accepted as a high-risk patient. Firstly the percutaneous intervention was tried through the ipsilateral femoral region but because of the occluded grafts, changing in anatomy and subcutaneous adhesions the percutaneous intervention were not been able to achieve. Contralateral percutaneous intervention was not tried due to not to cause harmfulness to the patent contralateral femoropopliteal bypass graft. So the region of ipsilateral femoral artery was exposured by local anesthesia and started the procedure by putting the sheath into the common femoral artery via open Seldinger technique.
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