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Extra-Anatomic Axillofemoral Bypass After Failed Stenting for Aortoiliac-Occlusive Disease in a Patient with Severe Comorbidities

Ketut Putu Yasa, Christopher Ryalino

(Department of Surgery, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia)

Am J Case Rep 2020; 21:e925009

DOI: 10.12659/AJCR.925009

BACKGROUND: 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.

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