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Femoropopliteal bypass (FPB) refers to revascularization of the ischemic lower limb using venous or synthetic graft to bypass occluded superficial femoral or proximal popliteal artery. Our aim was to evaluate the outcome of FPB for critical limb ischemia (CLI) or severe intermittent claudication (IC) in 2 vascular centres in Baghdad, Iraq. Forty eight patients (39 male) with CLI or IC were studied over 19 months. The mean age was 57.5±13.2 yr. All except 5 were studied retrospectively by medical charts review. Diagnosis included Doppler ultrasonography (DUS) and angiography. Standard operative technique was followed. Atherosclerosis was the main etiology (n=45, 93.7%). The main presentation was CLI (n=43, 89.6%). Diabetics stayed longer whereas patients receiving synthetic or vein grafts had similar hospitalization periods. DopplerUS was done in 33.4% of patients; and was conclusive in 43.8%. Angiography was done in 17 patients (35.4%); all except one had CT angiography. The predominant graft was the PTFE (n=34). There was one death (2.1%). Despite drawbacks of the study, early complications were nil, mortality was low, and twenty five out of 30 grafts (83.3%) remained patent during 6 months -1 year follow-up period. Longer followup is needed to evaluate the late outcome. Introduction F irst performed in 19491, femoro-popliteal bypass (FPB) refers to revascularization of the ischemic lower limb using either an autologous vein or synthetic graft to bypass an occlusion of the superficial femoral (SF) or the proximal popliteal artery2. The first indication for this procedure is critical limb ischemia (CLI) whilst the next is severe intermittent claudication. A practical and simple definition of CLI is that proposed by the European Working Group on CLI3. This group defined CLI as the presence of ischemic rest pain requiring analgesia for more than two weeks, or ulceration, or gangrene of the lower extremity with an ankle systolic blood pressure ≤50 mm Hg and/or toe systolic pressure ≤30 mmHg3. Although, chronic CLI in the vast majority of cases are related to advanced atherosclerotic disease, other diseases have to be kept in mind by the clinician, especially in young patients, those with ulcers in atypical locations, or those with few or no risk factors for CLI3. The presence of CLI is a clear indication to pursue an aggressive arterial revascularization to prevent limb loss and its associated increased mortality and morbidity3. The use of venous grafts have significantly improved patency rate compared with prosthetic grafts when anastomosed at the knee level (68% versus 38% at 5 yr.) or below (50% versus 12% at 5 yr); and therefore should be the preferred conduit for these anatomic sites3. The aim of this study was to evaluate the outcome of FPB for chronic lower limb ischemia in 2 tertiary vascular surgical centres in Baghdad, Iraq. Materials and Methods Over 19 month period (January, 1st 2012 to July, 31st 2013), forty eight patients (39 males and 9 females) with symptoms and Femoropopliteal Bypass for Chronic Lower Limb Ischemia Abdulsalam Taha, Nazar Sheikho & Akeel Yousr

FEMOROPOPLITEAL BYPASS FOR CHRONIC LOWER LIMB ISCHEMIA: REVIEW OF 48 CASES.