Abstract
Even though the use of endovascular treatment for critical limb ischemia is increasing, an open surgical procedure is still preferred for the limbs in patients with a longer life expectancy. If the great saphenous vein is unavailable, then bypass surgery should probably not be performed. We herein report a case in which bypass surgery was performed by using the arm vein conduits. The case was a 57-year-old male with critical limb ischemia. The bilateral great saphenous veins had been used at previous bypass surgeries; therefore, he did not have any available autogenous vein grafts in the lower extremity. In the left upper extremity, he had an arteriovenous fistula for hemodialysis. His right side arm vein diameter was almost 2 mm, and the arteriovenous fistula between the right side of the brachial artery and arm vein was found to have dilated the right side arm veins. Given the sufficient diameter of the arm vein conduits, we performed distal bypass surgery, and accomplished good healing of the ulcer. An arm vein conduit can be used as an alternative to the great saphenous vein for autogenous vein grafting, and therefore, clinicians should evaluate the arm veins and consider using them as a conduit for bypass surgery in cases with critical limb ischemia.
