55 year old heavy smoker gentleman presented with pain on walking in both legs involving the calves, thighs and buttock muscles relieved on resting. There was no pain at night. There was a history of impotence.
A CT Angiogram ordered showed iliac arteries occluded both legs with good filling through collaterals below the common femoral arteries till the ankles.
CT angiogram aorta and legs
Since the aorta was patent well below the renals and well palpable the patient underwent an Aorto-bifemoral bypass using a bifurcating synthetic craft from the aorta to the common iliac bilaterally.
The graft originating from the aorta.
Post-operative recovery was uneventful and patient was discharged on the 6th day and has been followed up in the OPD with no circulatory complaints.