Rare image of a patent axillopopliteal PTFE graft bypass with postoperative 3D-reconstructed angiogram

Extra-anatomical bypass surgery is commonly performed in patients with claudication, critical limb ischemia, or extensive aortoiliac disease and other arterial problems in the lower extremities. A single continuous axillopopliteal bypass grafting surgery is not very common. A 58-year-old male with critical limb ischemia underwent right axillopopliteal bypass surgery with polytetrafluoroethylene graft. After the surgery, periodic surveillance was performed with duplex ultrasonography and clinical assessment of peripheral pulses. Multidetector computed tomographic angiography (CTA) was also performed to determine the position and patency of the graft; it showed good contrast opacification from axillary artery to popliteal artery. CTA has become a powerful tool for assessing the potential complications of bypass grafting and for planning further therapy in a fast, reliable, and non-invasive manner.