Rerouting Arterial Flow to Relieve Ischemia*

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Abstract
Blood flow to an ischemic area may be re-established over a route other than that of the bypasses or replaced artery as has been done frequently for technical convenience. Similar unorthodox by passes have been performed to lessen the magnitude of an operation in poor-risk patients or to avoid an area of infection. Although indications for such bypasses are limited, 6 cases are reported. In 4 rerouting was from one femoral area to the other. In 3 the hazard of a major operative procedure was the indication. In the 4th infection prevented an ilio-femoral bypass and only a femoro-femoral bypass was possible. In the 5th patient axilliary-femoral bypass was done because of retroperitoneal infection. In the 6th carotid-carotid artery bypass was performed in anticipation of resection of the left common carotid artery. Although there is evidence that such bypasses disturb normal hemodynamics, patients surviving in this and other series had satisfactory revascularization.