Descending thoracic aorto bifemoral artery bypass for Aortoiliac occlusive disease :A novel anterior subcutaneous tunnel approach

Abstract

Descending thoracic aortobifemoral bypass via novel anterior subcutaneous tunnel approach was evaluated in 31 patients. Indications for this approach were; infrarenal aortic block with no site for infrarenal aortic clamping(18 cases), calcified infrarenal aorta(11 cases) and history of laparotomy(2 cases). Duration of surgery was 1.5 to 3 hours and blood loss was 300ml to 1000ml. There was mortality of 2 patients. Reexploration due to bleeding was done in 3 patients and 3 patients required prolonged ventilatory support for 2 days. This approach is recommended in selected patients where conventional approach to the abdominal aorta is not feasible. Follow up of 27 pateints had patent grafts in 24 patients and blocked grafts with no symptoms in 3 patients. 2 patients were lost to follow up.