Reoperative approaches to failed procedures confined entirely to the abdominal aorta

Options do exist when the vascular surgeon is faced with failed procedures confined to the abdominal aorta. Knowledge of the various techniques outlined previously allows an orderly and minimal-risk approach in these patients. Use of the original graft is often the first choice to revascularize ischemic lower extremities in low-risk patients. Extra-anatomic bypasses are generally reserved for high-risk patients. The exception is hepatorenal and splenorenal bypasses that are the revascularization method of choice in most patients with failed unilateral aortorenal bypasses.