Background: Bypass procedures related to the popliteal, anterior tibial, posterior tibial, peroneal and plantar arteries and tibioperoneal trunk have a great importance in the treatment of infrapopliteal atherosclerotic occlusive diseases.

Methods: In our study, 95 cases operated for infrapopliteal atherosclerotic disease between 1990-1999 were examined including follow up and results. The most common inflow site was the common femoral artery (71.13%). Distal anastomoses were performed on infrapopliteal artery in 68.42%, posterior tibial artery in 13.68%, the tibioperoneal trunk in 11.58% and the anterior tibial artery in 6.31% of the cases. The most commonly used graft material was the autogenous saphenous vein.

Results: The first and the second year patency rates for below knee popliteal artery bypasses were 88.2% and 80.2%, respectively. It was 76.3% and 67% for anterior tibial artery, 81.3% and 76.6% for tibioperoneal trunk, 78.2% and 62.3% for posterior tibial artery bypasses. For the reversed autogenous saphenous vein group, the first and second year patency rates were 87.5% and 79.4%. For in situ autogenous saphenous vein group it was 83% and 75.6%. These rates were significantly higher compared to the polytetrafluoroethylene used group (59.5% and 50.8%).

Conclusions: All infrapopliteal arteries can be used as outflow tract in femorodistal bypass surgery. Infrapopliteal bypasses can be performed easly using autogenous saphenous vein grafts and the results are better.

Keywords : Distal bypass, autogenous saphenous vein, polytetrafluoroethylene, graft