Both OSI and RRT values resulted higher when PG was preferred to DS and also areas with disturbed flow resulted wider. The absolute higher values computed by means of CFD were observed when PG was used indiscriminately regardless of carotid diameters. DS does not seem to create negative hemodynamic conditions with potential adverse effects on long-term outcomes, in particular when CEA is performed at the common carotid artery and/or the bulb or when ICA diameter is greater than 5.0 mm.
We present a new intra-abdominal extra-anatomic bypass graft for a 64-year-old man treated with an abdominal aortic endograft and with signs of endograft infection. We performed surgical removal of the endograft and intra-abdominal extra-anatomic reconstruction of a hepatic-to-right external iliac artery bypass with autologous superficial femoral vein and a crossover graft between the right and left external iliac artery with the great saphenous vein. The later occlusion of the saphenous vein graft led us to perform a femoral-femoral prosthetic crossover. At 42 months from the intervention, the patient was in good health, and duplex scanning confirmed the patency of all grafts.
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