Endovascular Revascularisation Of A Chronic Occluded Aortobifemoral Bypass.

Bilateral limb occlusion after aortobifemoral prosthesis occurs in 1-3% patients. Multiple remedial choices are known in literature to manage a bilateral occluded ABF such as "redo" aortobifemoral bypass (rABF), axillobifemoral bypass, endovascular recanalization of the native aortoiliac system and thrombectomy. We present a patient with an occluded aortibifemoral bypass since 2001. A new minimal invasive treatment strategy was performed by traversing the occluded limbs with aortic re-entry using stiff Terumo wires. To make way for safe passing of the stents kissing balloon angioplasty was performed of the entire aortobifemoral bypass. Kissing Viabahn (W. L. Gore & Associates, Flagstaff Arizona, USA) balloon-expandable stents (VBX) were placed in the proximal part of the aortobifemoral bypass and extended with a Viabahn self-expandable stent (standard Viabahn) This option should be added to the known multiple remedial choices in case of bilateral limb occlusion of an ABF.