The Esmarch bandage is an effective substitute for vascular clamps in distal femoro-popliteal or tibial bypass surgery. Intimal trauma caused by clamping is avoided, vasa vasorum are preserved due to only semicircumferential dissection of vessels. This method is particularly suitable for heavy calcified rigid vessel walls. We demonstrate this technique, which was employed in 8 patients (10 bypasses). The use of this technique requires neither a longer operation- nor clamping time. The postoperative course of all but one patients develops normally and the technique does not provoke any pathological results in the area of operation. Advantages of the procedure compared to conventional techniques will be discussed.
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