[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-416501-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-416501-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","aortoprofunda-and-internal-iliac-bypass-in-open-repair-of-abdominal-aortic-aneurysm-with-aortoiliacocclusive-disease","Aortoprofunda and internal iliac bypass in open repair of abdominal aortic aneurysm with aortoiliacocclusive disease","","An 83-year-old man with prior coronary bypass and iliac stenting presented with bilateral claudication and unmeasurable ankle–brachial indices. Computed tomography showed an infrarenal abdominal aortic aneurysm and bilateral iliac occlusion with severe calcification, while distal runoff depended on profunda femoris collaterals. Open repair used infrarenal aortic replacement with a three-branched graft to the right internal iliac and bilateral profunda femoris arteries. Postoperatively, ABI improved to 0.58/0.57, imaging confirmed graft patency, and symptoms resolved, supporting these arteries as effective outflow targets when conventional options are not feasible.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/aortoprofunda-and-internal-iliac-bypass-in-open-repair-of-abdominal-aortic-aneurysm-with-aortoiliacocclusive-disease/416501/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/aortoprofunda-and-internal-iliac-bypass-in-open-repair-of-abdominal-aortic-aneurysm-with-aortoiliacocclusive-disease/416501.png","ImageObject",300,407,{"name":42,"@type":43},"Franzy","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What were the key preoperative findings in the reported patient?","Question",{"text":63,"@type":64},"The patient had bilateral claudication with immeasurable ankle–brachial indices. CT showed an infrarenal abdominal aortic aneurysm and bilateral iliac occlusion with severe calcification, and runoff depended on profunda femoris collaterals.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the open repair performed in this case?",{"text":68,"@type":64},"Open infrarenal aortic replacement was performed using a three-branched graft. The graft connected to the right internal iliac artery and the bilateral profunda femoris arteries, with careful dissection and graft tunneling.",{"name":70,"@type":61,"acceptedAnswer":71},"What outcomes were observed after surgery?",{"text":72,"@type":64},"Postoperatively, ankle–brachial indices improved to 0.58/0.57. Imaging confirmed graft patency, and the patient’s symptoms resolved.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},416501,1790766327,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":111,"preview_page_count":4},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Journal of Surgical Case Reports, 2026, 1, rjaf1020  \n[https://doi.org/10.1093/jscr/rjaf1020](https://doi.org/10.1093/jscr/rjaf1020)  \nCase Report  \nCase Report  \nAortoprofunda and internal iliac bypass in open repair of abdominal aortic aneurysm with aortoiliacocclusive disease  \nYuki Akaguma*, Hideki Tsubota  , Masanori Honda, Masafumi Kudo  , Hitoshi Okabayashi  \nDepartment of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, 1 Katsuragosho-cho, Nishikyo-ku, Kyoto 615-8087, Japan  \n*Corresponding author. Department of Cardiovascular Surgery, Mitsubishi Kyoto Hospital, 1 Katsuragoshocho, Nishikyo-ku, Kyoto 615–8087, Japan.  \nE-mail: [akagumayuki@gmail.com](akagumayuki@gmail.com) .  \nAbstract  \nAn 83-year-old man with prior coronary bypass and iliac stenting presented with bilateral claudication. Ankle–brachial indices were immeasurable. Computed tomography revealed an infrarenal abdominal aortic aneurysm and bilateral iliac occlusion with severe calcification, while runoff depended on profunda femoris collaterals. Open repair was performed with infrarenal aortic replacement using a three-branched graft to the right internal iliac and bilateral profunda femoris arteries. Postoperatively, ankle–brachial indices improved to 0.58/0.57, imaging confirmed graft patency, and symptoms resolved. This case highlights profunda femoris and internal iliac arteries as effective outflow targets when conventional aortobifemoral bypass is not feasible.  \nKeywords: abdominal aortic aneurysm; aortoiliac occlusive disease (AIOD); aortoprofunda bypass; internal iliac artery; profunda femoris artery  \nIntroduction  \nAortoiliac occlusive disease (AIOD) frequently presents with intermittent claudication or critical limb ischemia, and aortobifemoral bypass is considered the gold standard surgical treatment for extensive lesions. However, in cases where the common femoral or iliac arteries are unsuitable as outflow vessels, alternative targets such as the profunda femoris may be required. Concomitant abdominal aortic aneurysm (AAA) with AIOD presents an additional challenge, as both aneurysm exclusion and durable limb revascularization must be achieved.Although aortoprofunda bypass has been reported as a reliable option, cases combining aneurysm replacement with multiple distal reconstructions involving the profunda femoris and internal iliac arteries are rare. We report a case of AAA with AIOD successfully treated by open aortic replacement and concomitant bypass to the bilateral profunda femoris and right internal iliac arteries. Patient consent for publication was obtained.  \nCase report  \nAn 83-year-old man with a history of coronary artery bypass grafting, diabetes mellitus, dyslipidemia, and hypertension presented with intermittent claudication of both legs. Eleven years  \nearlier, he had undergone stent placement in the right common and external iliac arteries for AIOD. At this presentation, ankle– brachial indices (ABI) were immeasurable bilaterally. Contrastenhanced computed tomography (CT) revealed an infrarenal AAA and occlusion of the right external and left common iliac arteries due to severe atherosclerosis and calcification (Fig. 1 , Video 1) . The bilateral superficial femoral arteries were heavily calcified, and distal runoff was dependent on profunda femoris collaterals. Therefore, surgical planning included open AAA repair with concomitant aorto–bilateral profunda femoris bypass. The right internal iliac artery had favorable quality and was also selected as an additional outflow target.  \nThrough a transperitoneal midline incision, the infrarenal abdominal aorta and bilateral iliac arteries were exposed. Bilateral groin incisions were made to isolate the profundafemoris arteries. The peritoneum anterior to both external iliac arteries was incised and extended by blunt dissection to the groins, creating graft tunnels that passed posterior to the ureters. After systemic heparinization, the infrarenal abdominal aorta and right intern","cbCaitpYCyPEtizv","https://ap.wps.com/l/cbCaitpYCyPEtizv","pdf",400802,"English","# Introduction\n## Case report\n## Figures and preoperative imaging\n## Surgical technique and graft reconstruction","[{\"question\":\"What were the key preoperative findings in the reported patient?\",\"answer\":\"The patient had bilateral claudication with immeasurable ankle–brachial indices. CT showed an infrarenal abdominal aortic aneurysm and bilateral iliac occlusion with severe calcification, and runoff depended on profunda femoris collaterals.\"},{\"question\":\"How was the open repair performed in this case?\",\"answer\":\"Open infrarenal aortic replacement was performed using a three-branched graft. The graft connected to the right internal iliac artery and the bilateral profunda femoris arteries, with careful dissection and graft tunneling.\"},{\"question\":\"What outcomes were observed after surgery?\",\"answer\":\"Postoperatively, ankle–brachial indices improved to 0.58/0.57. Imaging confirmed graft patency, and the patient’s symptoms resolved.\"}]","Aortoprofunda and internal iliac bypass in open repair of abdominal aortic aneurysm with aortoiliacocclusive disease | PDF",1790605676]