Extra-Anatomic Axillofemoral Bypass After Failed Stenting for Aortoiliac-Occlusive Disease in a Patient with Severe Comorbidities

Patient: Male, 59-year-old Final Diagnosis: Chronic bilateral limb ischemia Symptoms: Difficulty in walking Medication: — Clinical Procedure: Extraanatomic axilofemoral bypass Specialty: Anesthesiology • Surgery OBJECTIVE: Unusual clinical course BACKGROUND: An extra-anatomic bypass is the choice of revascularization method for limb salvage in patients with infra-renal aortailiac occlusion accompanied by severe comorbidities. CASE REPORT: We report a case of aortailiac-occlusive disease in a 59-year-old man with severe cormobidities. He had complained about intermittent claudication in both lower limbs for the past 10 years. The condition had worsened over the last 5 months, making it difficult for him to walk. Three attempts had been made at percutaneous aortailiac stenting, all of which were unsuccessful. The patient had a history of coronary artery disease and complete revascularization by percutaneous coronary stenting 10 years ago. Extra-anatomic axillounifemoral bypass was performed under general anesthesia. The results were good, with improvement in the patient’s distal perfusion immediately and at 1-month follow-up. CONCLUSIONS: After failed aortoiliac stenting, when direct revascularization aortofemoral bypass and endovascular intervention could not be carried out, extra-anatomic axillofemoral bypass was effective for revascularization in a patient with aortoiliac-occlusive disease and severe comorbidities.