2018 Volume 27 Issue 1 Pages 45-48
A 62-year-old man presented to our hospital complaining of an intractable foot ulcer. Angiography showed a disruption of the dorsalis pedis and posterior tibial arteries. Collateral circulation provided blood flow to the plantar artery. Endovascular therapy (EVT) for the occluded posterior tibial artery was unsuccessful, so a popliteal-plantar artery bypass was performed. Distal venous arterialization was chosen due to poor distal run-off preventing bypass flow immediately after declamping. Debridement and vacuum-assisted closure (VAC) for the ulcer were begun after the surgery. The foot ulcer had completely healed 6 months after the operation. DVA can be considered an option for cases with a difficult distal bypass.