Use of thoracic aortobifemoral artery bypass grafting as an alternative procedure for occlusive aortoiliac disease.

A descending thoracic aortobifemoral artery bypass graft is proposed as an alternative procedure for revascularization of the lower extremities when an intra-abdominal approach is not feasible or is ill-advised. Three patients underwent a thoracobifemoral graft because of severe cardiopulmonary disease combined with multiple prior abdominal surgeries, complications of radiation, and sepsis. Patency of the aortobifemoral grafts was documented by palpable pulses and increased ankle: brachial ratios improving from 0.3 to 0.6, resulting in the relief of rest pain and obviating a limb-threatening situation.