Abstract
A 60-year-old male patient presented with occlusion of his right superficial artery and stenosis of his right common femoral artery combined with severe calcification. In March 2013, he underwent common femoral endarterectomy and a femoropopliteal bypass（F-P bypass）with a prosthetic graft. In May, he was hospitalized to undergo treatment for critical limb ischemia of his bilateral lower limbs. Numerous revascularization procedures were performed, but his symptoms did not improve. He underwent bilateral below-the-knee amputation for limb salvage in July. His wound healed, and his ability to perform daily activities steadily improved with rehabilitation. However, in January 2014, he felt pain and a cold sensation below his right knee. Ultrasonography demonstrated that his F-P bypass graft was occluded. He was diagnosed with acute limb ischemia. We performed endovascular therapy（EVT）and thrombolytic therapy, but it was not effective. The next day, we carried out profundoplasty and Fogarty embolectomy. Although the patient’s symptoms improved temporarily, re-occlusion of the bypass graft occurred on the day after the operation. Finally, we revascularized the deep femoral artery via EVT to avoid hip disarticulation. After the EVT, the patient underwent an above-the-knee amputation. The necrosis did not progress. The patient was discharged to his home with the help of a walker.
