title: Thoracic aorta transobturator bipopliteal bypass as eventual durable reconstruction after removal of an infected aortofemoral graft.
abstract: A 36-year-old man was referred with aortofemoral graft infection and perigraft duodenal erosion. The aortofemoral graft was removed, and bilateral axillo-superficial femoral grafts were constructed. Recurrent failures of these grafts prompted us to convert to a more-durable reconstruction. A straight graft was anastomosed to the lower thoracic aorta, routed retroperitoneally, and attached to an inverted U-shaped bilateral transobturator bypass graft, which was anastomosed to both above-knee popliteal arteries. After 3 years, the patient has remained well and the grafts are patent. This operation represents a durable in-line reconstruction that avoids all previously infected areas after removal of an infected aortofemoral graft.
authors.affiliation: Department of Vascular Surgery, Hadassah University Hospital, Jerusalem, Israel.
authors.forename: Y G
authors.initials: YG
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Sasson
authors.forename: D G
authors.initials: DG
authors.lastname: Wolf
authors.forename: J M
authors.initials: JM
authors.lastname: Gomori
authors.forename: H
authors.initials: H
authors.lastname: Anner
authors.forename: Y
authors.initials: Y
authors.lastname: Berlatzky
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D011150:Popliteal Artery / Q000601:surgery*; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation