Major vascular reconstruction using prosthetic implantation is uncommon in the HIV infected patient. We describe a 52-year-old man with HIV infection and HIV-induced thrombocytopenia, who underwent successful aorto-bifemoral bypass for lower extremity ischemic symptoms. Postoperative progressive thrombocytopenia and subsequent hemorrhage were successfully treated with intravenous steroid replacement, platelet transfusion, alpha-globulin administration and expectant management. This report serves to illustrate that major vascular reconstruction can be successfully accomplished in the HIV infected population, even in the presence of significant hematologic dysfunction.

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