UCSF

Femoral artery stenosis is a rare but serious complication of arterial puncture in neonates, and surgical revascularization is challenging due to small vessel size. We report the case of a premature newborn with limb-threatening ischemia from femoral artery stenosis treated using the native umbilical artery as an autologous bypass graft. The umbilical artery was mobilized, tunneled, and anastomosed distal to the stenosis, restoring perfusion. Postoperative Doppler confirmed graft patency and resolution of ischemia. The patient later died from unrelated respiratory complications. This case highlights the technical feasibility of umbilical artery bypass for neonatal limb salvage and underscores the vulnerability of premature infants.