Fung Kristi, Rajaram-Gilkes Mathangi, Moglia Taylor, Rieker Finn G, Falkenstein Catherine
Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA.
Anatomy, Geisinger Commonwealth School of Medicine, Scranton, USA.
Cureus. 2024 Oct 16;16(10):e71618. doi: 10.7759/cureus.71618. eCollection 2024 Oct.
Femoro-femoral bypass grafts (FFBG) are performed to connect the major vessels of the lower extremities, such as the femoral arteries, to treat patients who have injured or occluded iliac arteries. Typically, patients with multiple comorbidities, such as heart failure, aneurysms, or diabetes, have a significantly higher risk of complications for open, invasive procedures to correct lower limb ischemia. This graft poses as an effective, less invasive option to treat lower-limb ischemia for higher-risk patients. This case study presents a finding of FFBG in an 82-year-old male cadaver during cadaveric dissection in the gross anatomy lab at Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania. Based on the initial findings of cardiomegaly with a triple coronary artery bypass graft (CABG) and pulmonary hypertension in the thoracic cavity and evidence of massive umbilical hernioplasty involving extensive mesh repair, our initial assumption of an FFBG placement in this cadaver was to increase perfusion to lower limbs, circumventing the need for surgical intervention due to the above-mentioned comorbidities, which act as risk factors. However, the discovery of a massive abdominal aortic aneurysm (AAA) measuring 26 cm in circumference with evidence of dissection of its wall and the presence of a stent within the aorta and common iliac arteries placed there as an endovascular aneurysm repair (EVAR) procedure came as a surprise. Publication of such findings provides awareness to curious individuals about the existence of multiple health concerns an individual suffers and how the medical as well as surgical teams work together to provide optimal treatment care to improve their standard of living and prolong their lifespan.
股-股旁路移植术（FFBG）用于连接下肢的主要血管，如股动脉，以治疗髂动脉损伤或闭塞的患者。通常，患有多种合并症（如心力衰竭、动脉瘤或糖尿病）的患者，进行开放性侵入性手术来纠正下肢缺血时，并发症风险显著更高。这种移植术为高风险患者治疗下肢缺血提供了一种有效、侵入性较小的选择。本病例研究展示了在宾夕法尼亚州斯克兰顿的盖辛格联邦医学院大体解剖实验室进行尸体解剖时，在一名82岁男性尸体中发现的FFBG。基于胸腔中心脏肥大伴三支冠状动脉旁路移植术（CABG）和肺动脉高压的初步发现，以及涉及广泛补片修复的巨大脐疝修补术的证据，我们最初认为在该尸体中放置FFBG是为了增加下肢灌注，避免因上述作为危险因素的合并症而进行手术干预。然而，发现一个周长26厘米的巨大腹主动脉瘤（AAA），其壁有夹层证据，且在主动脉和髂总动脉内有作为血管内动脉瘤修复（EVAR）手术放置的支架，这令人惊讶。公布这些发现可让好奇的人了解一个人所患的多种健康问题，以及医疗团队和外科团队如何共同努力提供最佳治疗护理，以提高他们的生活水平并延长寿命。
