Descending thoracic aorta to femoral artery bypass

Anatomic placement of a synthetic graft from the infrarenal aorta to the iliofemoral vessels has been a long recognized technique used to bypass occlusive disease of the distal aorta and iliofemoral arteries. However, in a few select patients with failure or infection of the abdominal graft, or in patients with a "hostile" abdomen from multiple prior operations, the descending thoracic aorta may be used as an inflow source for the iliofemoral vessels. This paper will discuss the indications, patency data, and technique of descending thoracic aorta to femoral artery bypass with a case presentation.