ABSTRACT
The novel concept of extra-anatomic bypass appeared more than four decades ago and this procedure has now become a widely used and accepted method of revascularization. It is mainly performed for patients who, due to comorbid conditions, are poor surgical risks for standard revascularization procedures or for those who have had a complication related to a previous bypass, such as an infected aortic graft or aortoduodenal fistula. The four types of extra-anatomic bypass commonly used include axillofemoral, femorofemoral, obturator, and thoracofemoral grafts. Because the majority of patients undergoing these procedures are poor surgical risks, any complication can be catastrophic. For this reason it is important that the vascular surgeon be aware of the complications associated with these procedures, so as to avoid complications when possible and to intervene in a timely manner when they do occur. This chapter reviews the diagnosis and management of complications commonly associated with extraanatomic bypass procedures.
