Coronary artery bypass grafting with left inferior epigastric artery as collateral

Area of Science:

• Vascular Surgery
• Cardiology
• Medical Case Reports

Background:

• Co-existent coronary artery disease (CAD) and peripheral artery disease (PAD) presents complex clinical challenges.
• Iliac artery occlusion significantly compromises lower extremity blood flow.

Observation:

• A 72-year-old female presented with triple-vessel CAD and bilateral iliac artery occlusion.
• A prominent left internal mammary-inferior epigastric artery collateral pathway provided major blood supply to the lower extremities.

Findings:

• Surgical intervention included coronary artery bypass grafting and right axillo-bifemoral bypass.
• The robust left inferior epigastric artery was successfully utilized as an arterial conduit to the circumflex artery.

Implications:

• This case highlights the critical role of collateral circulation in maintaining tissue perfusion in severe PAD.
• Successful revascularization strategies can be achieved even in complex cases of multi-site arterial disease.
• Demonstrates the versatility of the inferior epigastric artery as a conduit in complex bypass procedures.