A Rare Case of a Long-Term Patent Axillobipopliteal Bypass – A Case Report

Czech version

Authors: H. Pluháčková; R. Staffa; R. Vlachovský; T. Novotný; M. Dvořák
Authors‘ workplace: II. chirurgická klinika FN u sv. Anny v Brně a LF MU, přednosta: prof. MUDr. Robert Staffa, Ph. D.
Published in: Rozhl. Chir., 2011, roč. 90, č. 10, s. 575-578.
Category: Case Report

Overview

Introduction:
One of the options for the treatment of vascular graft infection in the aortoiliofemoral region is its explantation and extra-anatomical reconstruction. The authors present a rare case of a long-term patent axillobipopliteal bypass.

Case report:
A polymorbid patient with complete infection of the aortobifemoral prosthetic graft, with abscess in the groin and bilateral occlusion of the superficial femoral artery was treated by complete graft explantation and implantation of extra-anatomical axillobipopliteal bypass. The occlusion of the distal part of the left limb of the graft after 6 years was successfully solved by reoperation – replacement with a new vascular prosthesis.

Discussion:
The advantage of the extra-anatomical axillo(bi)femoral/popliteal reconstruction is its usability in urgent conditions. However, this reconstruction is associated with a high risk of graft thrombosis because of the length of the graft. Currently, we prefer an autogenous femoral vein for the treatment of the graft infection in the aortoiliofemoral region.

Conclusion:
Although the long-term results of the axillo(bi)femoral/popliteal reconstructions are generally not favourable, the secondary patency of the extra-anatomical bypass in presented patient is maintained for more than 6 years.

Key words:
extra-anatomical reconstruction – axillo(bi)femoral/popliteal bypass – vascular graft infection

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