title: Temporary axillobifemoral bypass as an adjunct to endovascular aneurysm repair using fenestrated stent grafts.
abstract: Prolonged endovascular procedures requiring a large diameter sheath in each groin can be associated with significant intraoperative lower limb ischemia, particularly in those with pre-existing peripheral vascular disease. We report the case of a patient who suffered severe ischemia-reperfusion injury following endovascular repair of a pararenal aortic aneurysm using a fenestrated stent graft and describe the use of temporary axillobifemoral bypass in a patient with similar comorbidities undergoing the same procedure. We propose this adjunctive technique as a means of maintaining antegrade limb perfusion and avoiding the peripheral and central metabolic consequences of ischemia-reperfusion injury.
authors.affiliation: Multidisciplinary Endovascular Team, University College Londonand University College London Hospital, London NW12BU United Kingdom. brianjmanning@gmail.com
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Manning
authors.forename: Obiekezie
authors.initials: O
authors.lastname: Agu
authors.forename: Toby
authors.initials: T
authors.lastname: Richards
authors.forename: Krassi
authors.initials: K
authors.lastname: Ivancev
authors.forename: Peter L
authors.initials: PL
authors.lastname: Harris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000601:surgery*; D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D015897:Comorbidity; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D017809:Fatal Outcome; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D011474:Prosthesis Design; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*; D015607:Stents; D016896:Treatment Outcome