Obturator bypass in the treatment of prosthetic graft infection: Classic but still effective

Area of Science:

• Vascular Surgery
• Infectious Disease Management

Background:

• Aortic graft infection, particularly following aortobifemoral bypass, presents a severe clinical challenge with high mortality and morbidity.
• Managing lower extremity ischemia secondary to infected inguinal grafts requires innovative surgical solutions.

Observation:

• A 60-year-old male presented with bilateral groin wound infection and critical lower extremity ischemia one year post-aortobifemoral bypass.
• The patient's condition indicated a failing or infected bypass graft in the inguinal region.

Findings:

• Surgical resection of the infected aortobifemoral graft was performed.
• A bilateral obturator bypass was successfully implemented as an extra-anatomical bypass solution.
• The obturator bypass demonstrated high patency and effectively addressed the lower extremity ischemia.

Implications:

• The obturator bypass is a viable and effective strategy for lower extremity revascularization when the inguinal region is compromised or infected.
• This approach offers a favorable option for managing recurrent graft infections and preventing limb loss.
• Extra-anatomical bypasses like the obturator bypass provide crucial alternatives in complex vascular reconstructions.