Managing an infected femoral artery pseudoaneurysm after thoraco-bifemoral bypass with an innovative configuration.

An infected femoral artery pseudoaneurysm after aortic reconstruction is a devastating surgical complication associated with the morbidity of limb loss and pelvic ischemia with a reinfection rate of ≤10%. In the present case report, we have described a unique approach for an infected femoral pseudoaneurysm after thoraco-bifemoral bypass using an innovative configuration, in addition to an obturator bypass technique, in a patient with a complex vascular history. This unique approach made use of an existing limb of a thoraco-bifemoral bypass graft to provide inflow to two outflow conduits, the external iliac artery and superficial femoral artery, allowing for preservation of both pelvic and lower extremity perfusion.