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Axillofemoral bypass

Case contributed by James Sheldon
Diagnosis almost certain

Presentation

Known aortoiliac occlusive disease

Patient Data

Age: 60 years
Gender: Female
ct

Patent right axillo-bifemoral bypass. Numerous small collections are present along the course of the graft.

The pulmonary arteries opacify normally without filling defects to a subsegmental level.

Bilateral pleural effusions. Mild bibasal consolidation/collapse. No mediastinal, hilar or axillary lymphadenopathy. Right PICC line noted with tip in SVC.

Fat stranding is present anterior to the infrarenal abdominal aorta, which is occluded.

Ureteric stents in situ bilaterally, with prominence of the right renal pelvis and proximal ureter. Fatty infiltration of the liver with small stable low attenuation lesions consistent with cysts. The spleen, adrenal glands, pancreas and bowel are unremarkable.

ct

3D reconstruction demonstrating the axillofemoral bypass. 

Case Discussion

Axillofemoral bypass is a surgical method used in patients with symptomatic aortoiliac occlusive disease. It is most frequently performed when endovascular options are not suitable.

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