Ascending thoracic aortobipopliteal bypass for extensive aortoiliac and femoropopliteal arterial occlusive disease

This report describes a patient with disabling intermittent claudication resulting from the complex combination of a heavily calcified abdominal aorta, extensive aortoiliac occlusion, bilateral femoropopliteal arterial occlusion, and thrombosis of a previous right axillobifemoral bypass graft, followed by revision of the graft to the left proximal popliteal artery and subsequent graft removal because of chronic infection. The patient underwent successful ascending thoracic aortobipopliteal bypass surgery and had an uneventful postoperative recovery, with ankle pulses palpable bilaterally. After 6 years of follow-up, he could walk unlimited distances, and computed tomography angiography showed patent grafts.