A 70-year-old man with hypertension and hyperlipidemia presents with a 6-month history of progressive bilateral thigh and buttock claudication, erectile dysfunction, and absent femoral pulses bilaterally. CT angiography confirms aortic bifurcation occlusion. Which surgical procedure is the treatment of choice?

• A Aortobifemoral bypass grafting ✓
• B Axillobifemoral bypass grafting
• C Femorofemoral crossover grafting
• D Aortoiliac endarterectomy

Explanation

This patient has Leriche syndrome (aortoiliac occlusive disease). Aortobifemoral bypass is the gold standard with 10-year patency rates of 80-85%. Axillobifemoral bypass is reserved for high-risk patients unsuitable for intra-abdominal surgery due to lower patency rates. Femorofemoral crossover grafting is used for unilateral iliac disease with a patent donor iliac system. Endarterectomy has been largely superseded by bypass grafting for extensive disease.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.