Primary hyperoxaluria causing ESRD and gangrene of extremities leading to amputation

A novel innovative technique in the management of bilateral critical limb ischaemia: delayed saphenous vein autologous graft

A 31-year-old man with primary oxalosis and resultant polyneuropathy presented with worsening leg pain. He was found to have bilateral superficial femoral artery dissections with a non-viable left leg and critically ischaemic right leg. He underwent emergency left above-knee amputation with harvesting of the full-length ipsilateral great saphenous vein (GSV). In a novel technique, the vein was stored for 10 days before being used as conduit in a femoral-popliteal bypass in the contralateral leg. The success of the delayed GSV autograft means the salvage of clinically viable veins in non-viable limbs should be considered when patients present with bilateral acute or critically ischaemic limbs.