Extra-Anatomic Axillofemoral Bypass After Failed Stenting for Aortoiliac-Occlusive Disease in a Patient with Severe Comorbidities
Unusual clinical course
Ketut Putu Yasa, Christopher Ryalino
Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
Am J Case Rep 2020; 21:e925009
Available online: 2020-06-29
An extra-anatomic bypass is the choice of revascularization method for limb salvage in patients with infra-renal aortailiac occlusion accompanied by severe comorbidities.
CASE REPORT: We report a case of aortailiac-occlusive disease in a 59-year-old man with severe cormobidities. He had complained about intermittent claudication in both lower limbs for the past 10 years. The condition had worsened over the last 5 months, making it difficult for him to walk. Three attempts had been made at percutaneous aortailiac stenting, all of which were unsuccessful. The patient had a history of coronary artery disease and complete revascularization by percutaneous coronary stenting 10 years ago. Extra-anatomic axillounifemoral bypass was performed under general anesthesia. The results were good, with improvement in the patient’s distal perfusion immediately and at 1-month follow-up.
CONCLUSIONS: After failed aortoiliac stenting, when direct revascularization aortofemoral bypass and endovascular intervention could not be carried out, extra-anatomic axillofemoral bypass was effective for revascularization in a patient with aortoiliac-occlusive disease and severe comorbidities.
Keywords: Coronary Vessels, endovascular procedures, Microsurgery