Repair
Anastomoses
Embolectomy
Longitudinal incision
- midpoint ASIS and pubic symphysis
- open femoral sheath
- NAVY
- insert catheter into artery
- inject contrast and follow with II
Position
- patient supine
- leg externally rotated
Incision
- medial aspect distal thigh over sartorius
- extends over knee to 1 cm posterior border tibia
Superficial dissection
- divide deep fascia over sartorius
- retract sartorius anteriorly to expose femoral artery
- at the knee detach medial head of gastrocnemius to expose popliteal artery
- at tibia detach soleus to expose trifurcation
Anastomosis
- first clear artery with embolectomy
- vein patch graft or anastomosis with reversed great saphenous vein
- repair 6.0 prolene non cutting needle