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Related Experiment Videos

Axillomesenteric bypass: an unusual solution to a difficult problem.

Christos D Karkos1, Greg S McMahon, George Markose

  • 1Department of Vascular and Endovascular Surgery, Leicester Royal Infirmary, Leicester, United Kingdom. ckarkos@hotmail.com

Journal of Vascular Surgery
|February 1, 2007
PubMed
Summary
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A rare case of aortic occlusion in a 49-year-old woman was treated with a left axillomesenteric bypass. This less-invasive extra-anatomic bypass successfully resolved mesenteric ischemia and improved renal function.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Nephrology

Background:

  • A 49-year-old woman presented with acute anuric renal failure and severe hypertension.
  • Imaging revealed occlusion of the distal thoracic and abdominal aorta, indicating a critical vascular obstruction.

Observation:

  • Acute hemodialysis and blood pressure reduction exacerbated previously undiagnosed mesenteric ischemia.
  • The patient experienced repeated episodes of flash pulmonary edema, complicating her overall clinical condition.

Findings:

  • Thoracoabdominal reconstruction was not feasible due to the patient's precarious state.
  • A left axillomesenteric bypass using a 6-mm externally ringed PTFE graft was successfully performed as an alternative.
  • The patient recovered uneventfully, with rapid resolution of abdominal symptoms and remained symptom-free at 12 months.

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Implications:

  • Extra-anatomic bypass offers a viable, less-invasive solution for complex aortic occlusion cases when traditional repair is not possible.
  • This approach can effectively manage critical limb and mesenteric ischemia in high-risk patients.
  • Successful management highlights the importance of considering alternative surgical strategies in challenging vascular emergencies.