[Obturator foramen bypass for revascularization of the leg with infection of the femoral area. A clinical case]

Abstract

Infection of the femoral artery together with limb acute ischemia represent for the vascular surgeon a challenging condition to manage. To solve this complicated vascular problem in the groin, the obturator foramen bypass has been described as an alternative procedure for ischemic limb salvage. The authors report their experience with a diabetic patient admitted in critical conditions with an ischemic leg and sepsis of the femoral area due to an infected extra-anatomical crossover femoro-femoral bypass complicated by hemorrhagia and which was partially removed in another Hospital. Limb revascularization was achieved by an obturator foramen PTFE expanded iliopopliteal bypass. The residual infected prosthesic stump was, thereafter, removed from the groin wound. The post-operative period was uneventful and the patient was discharged in the XIII post operative day. At follow-up, latest control at 10 months (July 1993) documented a patent graft and an ankle pressure index > 1. This experience, and a review of the literature, confirm the validity of the obturator foramen bypass as a route of choice for infected femoral artery and ischemic limb salvage.