[Unusual procedures used in reconstructive surgery and/or revascularization of the aorta]

Since the advent of arterial surgery, four decades of development have evolved, characterized not only by a remarkable evolution of concepts, but also by the improvement of technics, means and methods utilized for arterial reconstructive surgery. This progress led to the promotion and improvement of the conventional surgical methods dedicated to the treatment of the most common aortic disorders, obstructive or aneurysmal. Endarterectomy, revascularization using synthetic bypasses or interposition of arterial prosthesis are the most common and standardized procedures which are used worldwide, giving gratifying and long lasting results, involving low or negligible risks. In clinical practice however one sometimes, faces rare conditions, poorly understood due to their rarity, in which the conventional methods may be regarded as inappropriate, unfit or even formally contraindicated. Some unusual or uncommon methods were devised to deal with such conditions, which are less popular due to their rarity, but may also be considered just as valid and reliable as conventional methods, bearing satisfactory and rewarding results. Among them we stress the bypass originated in the ascending aorta, the bypass from the descending thoracic aorta and the bypass arising from the supraceliac aorta. The main features of these procedures as well as the personal experience of their utilization obtained by the senior author constitute the essence of this presentation.