Aorto-bilateral External Iliac Artery Bypass Graft in a Patient with Leriche Syndrome and an Ileal Conduit

Tetsuya Kajiyama	Shinya Fukui	Masataka Mitsuno
Hiroe Tanaka	Masaaki Ryomoto and Yuji Miyamoto

（Department of Cardiovascular Surgery, Hyogo Medical University, Nishinomiya, Japan）

We report a patient with Leriche syndrome who had ileal conduit and a right lower quadrant stoma. A 47-year-old man with a history of bladder cancer had undergone radical total cystectomy with formation of an ileal conduit and right lower quadrant stoma 2 years previously. CT scanning revealed total occlusion of the distal aorta. He experienced right lower leg pain after 30m of walking. Through a repeat midline laparotomy incision, the abdominal aorta was dissected with a transperitoneal approach. To avoid dissection around the ileal conduit, the retroperitoneum was incised（open）at the right of the ascending colon and at the left of the sigmoid colon. A prosthetic graft（Interguard 14×7mm）was pulled bilaterally through these incisions, to the external iliac arteries. Abdominal aorto-bilateral external iliac artery bypass grafting was performed and the patient was discharged without complications on the 15th postoperative day.

　

Jpn. J. Cardiovasc. Surg. 43:158-161（2014）

Keywords：Leriche syndrome;ileal conduit, reoperation