Aortobipopliteal bypass via the obturator foramina

Patients with aortoiliac disease who have successive occlusion of aortofemoral bypass, femoro-femoral bypass, axillo-femoral bypass, and multiple thrombectomies have a very poor prognosis. In these patients, amputation is frequently inevitable and wound healing is often a problem. Aortobipopliteal bypass via the obturator foramina, without disturbing the collateral vessels which are unsuitable for bypass at the groin, is an alternate approach in the management of this type of patient. Three cases have been successfully constructed using dacron (No. 1) or PTFE (No. 2) prostheses with improvement of ankle brachial indices (0.3-0.6). One graft was patent for five years before occlusion of one limb. Two grafts have remained patent since 1983.