PMC6800891_01
Computed tomography angiogram of the abdomen, pelvis, and lower extremities with runoff (a). Computer generated pelvic vasculature demonstrating the stark difference (b).
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She underwent aorta-left femoral and aorta-right iliac bypass with a bifurcated polytetrafluorethylene (PTFE) graft (Figure 1).
(a) Exposure of the infrarenal aorta and occluded PTFE graft. (b) Cryopreserved aorto-right common iliac allograft (yellow arrow) with left limb anastomosed to an autologous left femoral vein conduit (green arrow) to extend to left common femoral artery. (c) Left femoral vein conduit to left femoral bifurcation anastomosis.
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However, her left leg pain progressively worsened and required an open surgical juxtarenal aortic thrombectomy and redo aorta-right common iliac,-left common femoral reconstruction with a bifurcated cryopreserved allograft spliced to an autogenous left femoral vein conduit (Figure 2).