Aorto-bilateral External Iliac Artery Bypass Graft in a Patient with Leriche Syndrome and an Ileal Conduit / 日本心臓血管外科学会雑誌

ABSTRACT

We report a patient with Leriche syndrome who had ileal conduit and a right lower quadrant stoma. A 47-year-old man with a history of bladder cancer had undergone radical total cystectomy with formation of an ileal conduit and right lower quadrant stoma 2 years previously. CT scanning revealed total occlusion of the distal aorta. He experienced right lower leg pain after 30 m of walking. Through a repeat midline laparotomy incision, the abdominal aorta was dissected with a transperitoneal approach. To avoid dissection around the ileal conduit, the retroperitoneum was incised (open) at the right of the ascending colon and at the left of the sigmoid colon. A prosthetic graft (Interguard 14×7 mm) was pulled bilaterally through these incisions, to the external iliac arteries. Abdominal aorto-bilateral external iliac artery bypass grafting was performed and the patient was discharged without complications on the 15th postoperative day.