Below-Knee Obturator Bypass to the Popliteal Artery with the Autologous Vein

Abstract

We report a case of obturator bypass from the external iliac artery to the below-knee popliteal artery with an autologous vein graft for a patient with MRSA prosthetic graft infection. A 67-year-old man presented with an infected right femoro-above-knee popliteal prosthetic bypass graft. Graft excision and extra-anatomic revascularization were scheduled, because the entire prosthetic graft was involved. Complete graft excision and obturator bypass to the below-knee popliteal artery using a great saphenous vein were performed simultaneously. The postoperative course was uneventful and he was discharged without recurrent infection or intermittent claudication. An obturator bypass to the below-knee popliteal artery using the autologous vein may be one treatment option in cases involving infection involving the whole graft, in cases of femoral artery to above-knee popliteal artery bypass.