A double bifurcated graft for abdominal aorta and bilateral iliac artery reconstruction

Revascularization of the hypogastric artery often tends to be neglected in aortoiliac reconstructive surgery; however, its incomplete revascularizatio n can result in unfavorable complications such as buttock claudication or n ecrosis, vascular impotence, and colonic ischemia. Multiple vascular lesion s in the abdominal aorta and bilateral iliac arteries were reconstructed us ing a newly designed double bifurcated graft in Eve male patients. All Eve patients demonstrated excellent graft limb patency and postoperative improv ement of the ankle-brachial pressure index without any clinical signs of is chemia in regions of the hypogastric artery. Thus, we conclude that an aggr essive approach toward hypogastric circulation maintenance is essential in aortoiliac reconstructive surgery. By using this double bifurcated graft, r apid and safe revascularization of the bilateral hypogastric arteries conco mitant with the external iliac or femoral arteries can be performed.