Axillofemoral bypass in elderly patients with local anesthesia: an alternative route to less risk

Exteriorized thrombosed axillo-bifemoral graft with empyema post coronary artery bypass grafting with axillo-femoral bypass

“…[1][2][3] The definitive treatment is graft excision followed by revascularization via extra-anatomical or in situ reconstruction. However, in clinical practice, care is adapted to the patient's comorbidities, and Samson's updated Szilagyi classification system of extra-cavitary vascular graft infection which correlates extent of infection with prognosis 3,4 When axillo-femoral graft infections occur in patients who have limited revascularization options and are unable to tolerate major re-operative procedures, complications arise. In such cases, rather than graft excision, the best treatment choice could be graft rescue or conservative antibiotic administration.…”

An axillofemoral bypass graft transgressing the chest wall

“…Prosthetic graft infection is a devastating outcome of aortoiliac revascularization procedures. It complicates 0.5–3.5% of patients , and has a mortality rate as high as 75% . Definitive management is graft excision with subsequent revascularization either by extra‐anatomical or in situ reconstruction.…”

“…Al‐Wahbi reported the successful revascularization of an ischemia foot in an octogenarian with an axillofemoral bypass graft under local anesthesia. Cappello et al . reported 100% success rate in limb revascularization at 30 days when spinal and local anesthesia were used to gain femoral and axillary access, respectively, in constructing an axillofemoral bypass.…”