Early postoperative femoral-distal bypass graft failure due to vascular clamp injury induced common femoral artery thrombosis.

Acute early postoperative femoral-distal bypass graft failure associated with profound lower extremity ischemia is unusual because early graft failure commonly reverts leg circulation to the preoperative status. Two cases are reported where the etiology of profound early postoperative ischemia and graft failure were not due to technical aspects of graft reconstruction itself but rather to vascular clamp injury to a severely atherosclerotic common femoral artery with early postoperative common femoral artery, profunda femoris artery and graft thrombosis. This event requires immediate recognition and common femoral artery reconstruction for limb salvage.