[Bilateral trans-obturator bypass after graft infection in the aorto-bifemoral position]

The authors describe a patient in whom bilateral transobturatory bypass for revascularization of the lower extremities after infection of the preliminary implanted graft in aorto-bifemoral position, was carried out. The graft was implanted into aorto-bifemoral position after angiographic examination of the patient hospitalized for claudicatory disorders. A year later the patient was hospitalized for infection of the left distal anastomosis manifested by haemorrhage. After re-establishment of haemostasis (ligature of the arteries in the Scarpa's triangle and of the left branch with Y Dacron graft) the infected part was extirpated. Revascularization of the left leg was performed in another surgical act, with transobturatory iliaco-deep-femoral artery (jumping)--popliteal bypass with the use of 8 mm tubular DACRON graft. Three months later infection and haemorrhage appeared in the right inguinal region i.e. on the right distal anastomosis. This time the extirpation of the infected right branch of Y DACRON graft and revascularization of the right leg with right transobturatory aorto-popliteal bypass were performed in one surgical act. Tubular DACRON graft of 8 mm was also used. This case is one of the good examples of appropriate extra-anatomic transobturatory bypass in the revascularization of the lower extremities when it is not possible to treat a process in the inguinal region by usual procedures. The curiosity of this case is the bilateral transobturatory bypass.