Clinically evident compromise of parietal or visceral pelvic function secondary to interruption of pelvic blood flow occurs infrequently after aortoiliac reconstruction. Certain patterns of aortoiliac or occlusive aneurysmal disease or graft infection may require exclusion of the hypogastric or profunda femoral arteries. In these situations collateral blood flow or retrograde iliac flow may be insufficient to perfuse the pelvis and may cause ischemia. We present three cases of postoperative pelvic ischemia and describe our efforts to restore pelvic perfusion.
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