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Axillomesenteric bypass: An unusual solution to a difficult problem

Published byPirkko Kouki Modified over 5 years ago

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Presentation on theme: "Axillomesenteric bypass: An unusual solution to a difficult problem"— Presentation transcript:

1 Axillomesenteric bypass: An unusual solution to a difficult problem
Christos D. Karkos, FRCS, PhD, Greg S. McMahon, MB ChB, MRCS, George Markose, FRCR, Robert D. Sayers, MD, FRCS, A. Ross Naylor, MD, FRCS  Journal of Vascular Surgery  Volume 45, Issue 2, Pages (February 2007) DOI: /j.jvs Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 A, Arteriogram via the axillary approach shows extension of thrombus into the distal thoracic aorta. B, A computed tomography angiogram (three-dimensional reconstruction, left anterior oblique view) shows occlusion of the distal descending and abdominal aorta. Note the extensive collateral network within the chest and abdominal walls, particularly the two pairs of very prominent internal mammary and inferior epigastric arteries. The common iliac arteries fill retrogradely up to the bifurcation, the hypogastric circulation is perfused in antegrade fashion, and the mesenteric circulation is supplied from retrograde flow in a large superior hemorrhoidal artery. Extensive collateralization exists between the superior mesenteric and the celiac artery networks. A dialysis catheter (DC) is present in the right common femoral vein. DTA, descending thoracic aorta; SMA, superior mesenteric artery; IMA, inferior mesenteric artery; WA, wandering artery of Drummond; RIEA, right inferior epigastric artery; LIEA, left inferior epigastric artery. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 At laparotomy, there was (A) subacute ischemia of the small bowel and (B) gallbladder. Both resolved immediately after revascularization. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 A computed tomography angiogram (three-dimensional reconstruction) 6 months after axillary–superior mesenteric artery bypass. The graft is clearly patent (AMG), a vein collar (VC) can be seen at the distal anastomosis, and there is a dialysis catheter (DC) in the right internal jugular vein. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

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