Below-Knee Angioplasty

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Abstract
The obturator bypass was initially employed to avoid the infected groin during revascularization. In the literature, placement of over 300 obturator bypass grafts has been reported for a variety of indications, although the number of procedures performed was undoubtedly much higher. Important factors that must be considered before performing such a bypass include the proper assessment of adequate inflow, outflow, and the anatomic site of infection or other complicating circumstances. Although different surgical approaches have been advocated by several authors, the technique will ultimately be determined by patient circumstances and physician resourcefulness. A recent review of the literature showed 1- and 5-year patency rates for all indications of obturator bypass to be 71% and 60%, respectively As the procedure is generally safe, this extraanatomic bypass may be used to circumvent a variety of obstacles that preclude a standard revascularization procedure. Therefore, the technique should be included in the armamentarium of the vascular surgeon.

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