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Blockage of the aorta or iliac arteries can be treated by bypass surgery. Early diagnosis can lead to treatment by angioplasty. Once the vessels have become occluded, bypass surgery is inevitable.

Unilateral occlusion of an iliac artery, blocking the blood supply to one leg, can be treated by a femoro-femoral crossover graft (see Figure 6.6). This involves taking blood from the top of the good leg into the top of the affected leg. This procedure does not reduce the blood supply to the good leg, because the amount of blood flowing into the good leg is controlled by the run off. If the run off is improved by diverting some blood into the other leg, then the inflow also increases. This procedure can be carried out without opening the abdomen. It is very effective, relatively straightforward and certainly applicable to patients whose general condition is poor.