Presentation
History of aortobifemoral bypass graft and right femoral endovascular stent few months earlier, now the patient complains of right leg ischemic symptoms.
Patient Data
Aorto-bifemoral bypass graft is seen, with occluded right graft limb.
Attenuated atherosclerotic native distal aorta,both common, external and internal iliac arteries. Focal significantly focal ostial stenosis of right common iliac artery.
Focal ostial stenosis of the celiac trunk and right renal artery.
Patent superior mesenteric and left renal arteries.
Occluded inferior mesenteric artery with collateral distal refilling.
Right lower limb arterial axis:
Occluded superficial femoral & popliteal endovascular stent .
Occluded common femoral artery.
Collateral refilling of the deep femoral artery and a short proximal segment of the native superficial femoral artery.
Collateral refilling of segments of the anterior tibial and peroneal arteries.
Occluded posterior tibial artery.
Left lower limb arterial axis:
Patent common,superficial ,deep femoral,popliteal,peroneal and posterior tibial arteries.
Occluded anterior tibial artery shortly after its origin.
Aortobiformal graft attachment at the aorta and the common femoral artery are demonstrated by (Red arrows).
Native aorta and iliac vessels (Blue arrows)
Occluded right limb of the graft (Yellow arrow)
Case Discussion
Aortobifemoral bypass grafting is a durable operation for arterial reconstruction in patients with aortoiliac occlusive disease.
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