EXPOSURE OF THE ANTERIOR TIBIAL ARTERY BY MEDIAL POPLITEAL EXTENSION

This report describes exploration of the proximal anterior tibial arte ry by extension of the standard below-knee approach to the popliteal a rtery. The anterior tibial artery is ''poplitealized,'' giving excelle nt access to perform an anastomosis. The proximal medial approach depe nds on precise arteriography and is particularly suited to the in situ saphenous vein bypass and redo surgery. Advantages over previously de scribed exposures include a shorter graft, ease of graft alignment, pr otection of the peroneal nerve, and the absence of a lateral counterin cision. This exposure has been used on 12 of 14 anterior tibial grafts during the past 2 years.