Abstract
Axillofemoral bypass grafts (AxFG) are widely accepted for the treatment of poor-risk patients with aortoiliac occlusive disease. However, AxFG are associated with a variety of complications in the upper extremities (UE). For example, UE thromboembolism after AxFG occlusion is known as axillofemoral stump syndrome (AxSS). Here we report the case of an 85-year-old man with repeat UE thromboembolism 3 years after an AxFG occlusion. Thromboembolectomies had been performed, but he was readmitted on an emergency basis because of 2 hours of pain in his left arm. An operation was immediately performed. The axillary portion of the graft was divided and a thromboembolectomy was performed. Postoperatively, the patient’s pulse fully returned. Histological examination revealed a mixed thrombus consisting of fibrin, erythrocytes platelets and leukocytes at the axillary portion of the occluded graft. AxSS was a significant complication of an occluded axillofemoral graft. It may be prudent to prophylactically detach the axillary portion of the graft and repair the axillary artery, in patients who do not require immediate revision of an occluded AxFG.
