Progressive atherosclerosis of the aortoiliac system in a patient with a functioning renal transplant is a vexing problem, but in transplant patients who have had aortoiliac reconstruction, progressive disease can be doubly difficult to treat. Our experience with a patient with an ischemic transplant due to occlusion of a previously placed aortoiliac bypass limb is recounted. Various surgical approaches were considered, but femoro-femoral bypass was successfully performed.
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