Extra-Anatomical Bypass for Chronic Mesenteric Ischemia with Saphenous Vein Grafts from a Previous Axillofemoral Artery Bypass Graft: A Case Report

A 74-year-old woman who was diagnosed with chronic mesenteric ischemia was under hemodialysis maintenance and had previously undergone axillobifemoral bypass surgery because of abdominal aortoiliac occlusion. Endovascular and antegrade or retrograde surgical revascularizations from the aortoiliac artery were contraindicated because of a severely calcified arteriosclerotic lesion, which included aortoiliac occlusion. During median laparotomy, revascularization consisting of bypass grafting from a previous prosthetic graft to the mesenteric arteries was performed using saphenous vein grafts. Although extra-anatomical bypass for chronic mesenteric ischemia is challenging, it provides a feasible option in cases where conventional endovascular or surgical revascularization is contraindicated.