[Direct approach for bypass of the distal deep femoral artery. The supra mediocrural route].

The medio-femoral route permits a simple, direct approach to the distal part of the profunda femoris artery outside Scarpas triangle, i.e. below the first perforating artery. The quadriceps femoris and sartorius muscles are separated. This segment may reach the lower part of the popliteal artery through various collaterals supplying the muscle and nerve arteries and, hence, the leg. In selected cases with severe ischemia and absent femoral pulse, a by-pass operation carried out at this level permitted one to obtain a satisfactory arterial blood supply to the leg and foot. Used in only three patients, with a follow-up of several months, we cannot yet draw final conclusions, but the quality of the early results is evidence for the interest of the method.