RESTORATION OF THE PELVIC CIRCULATION IN PATIENTS WITH ABDOMINAL AORTIC-ANEURYSMS RECEIVING AORTOBIFEMORAL GRAFTS

When operating on abdominal aortic aneurysms associated with stenoses or occlusions of iliac vessels, surgeons may face the problem of reest ablishing circulation to pelvic or gluteal territories. A new techniqu e consists of anastomosing a posterior opening in the body or one of t he branches of a bifurcated graft, distally sutured to the femoral art ery, to the distal aortic stump, which contains all the patent vessels arising from the end of the aorta, such as inferior mesenteric and lu mbar arteries. This technique, successfully performed in two cases, ha s the advantages of avoiding closure of the distal aortic stump and a possible backflow leak and of ensuring adequate pelvic circulation.