Descending Thoracic Aorto-bifemoral Bypass for Aortoiliac Occlusive Disease

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Introduction: Complete obstruction of the abdominal aorta at the renal artery level is a difficult surgical problem. Methods: From August 2010 to January 2014, descending thoracic aorta to femoral artery bypass grafting was used to re-vascularize the lower limbs of the patients in our center. We analysedd our results Results: Primary indication was lack of a suitable site for aortic clamping. Average duration of surgery was 2.5-4.5 h, and blood loss was 100-400 mL. We use BARD®, IMPRA® expanded polytetrafluoroethylene vascular graft for thoraco-bifemoral bypass surgery. There was one mortality due to myocardial infarction. Major morbidities were graft occlusion in one patient that was managed by embolectomy and ascites in another patient, managed conservatively. Conclusion: Thoracic aorta to femoral artery bypass is a simple extra anatomic bypass technique, which can be used in case of difficulty to use abdominal aorta for lower limb re-vascularization.