Outcomes of axillofemoral bypass for intermittent claudication

Levin, Scott R.; Farber, Alik; King, Elizabeth G.; Beck, Adam W.; Osborne, Nicholas H.; DeMartino, Randall R.; Cheng, Thomas W.; Rybin, Denis; Siracuse, Jeffrey J.

doi:10.1016/j.jvs.2021.12.048

Cited by 6 publications

(1 citation statement)

References 28 publications

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“…Traditional management of infected aortobifemoral grafts requires graft explant and extra-anatomic bypass, typically by axillobifemoral bypass grafting [3]. High morbidity has been seen with axillofemoral bypasses with a mortality of up to 30% in the early postoperative period [3][4][5] and also associated with a high degree of failure, graft occlusion, and limb loss [6]. Other documented strategies include staged revascularisation [3,4], neo-aortic reconstruction with femoral vein [4], and sometimes graft retention with long-term antibiotic therapy [7].…”

Section: Discussionmentioning

confidence: 99%

Low Morbidity Anatomical Revascularisation for an Infected Aorto-Bifemoral Graft Using a Staged Hybrid Procedure

Ding¹,

Farah²,

Haddad³

et al. 2023

Cureus

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A 66-year-old woman presented with a right femoral false aneurysm following an aortobifemoral bypass for lifestyle-limiting claudication. A computed tomography (CT) angiogram revealed features of complete aortobifemoral graft infection. A two-stage procedure was performed. The first hybrid stage involved the excision of only the femoral components and covered stenting of the aortic stump, along with recanalization of bilateral native iliac systems. The second stage, six weeks later, involved aortic stent and graft explant via midline laparotomy with aortic bovine pericardium patch repair (LeMaitre Vascular Inc, Burlington, Massachusetts). Follow-up imaging demonstrated no residual infection, and the patient remained without complication at the 12-month follow-up. This novel approach utilizes hybrid surgical techniques and modern bioprosthetic material to safely manage an infected aortobifemoral bypass graft.

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