Document Type

Article

Publication Date

2026

Abstract

An axillobifemoral bypass graft is an extra-anatomic bypass and is not the gold standard for peripheral revascularization treatment. The purpose of this case study is to determine the efficacy of alternative treatment options for graft stenosis. This case report follows a 77-year-old woman with an axillobifemoral graft presenting with claudication symptoms. An initial ultrasound duplex found near-occlusive stenoses at the anastomosis sites with moderate to severe ankle brachial index values. These findings influenced the decision to undergo an atherectomy to reestablish peripheral perfusion.

Ultrasound surveillance will be critical to maintaining graft patency and tracking stenosis development. Treatment with anticoagulation medicine alone, graft limb adjustment, or graft replacement with anticoagulation wall lining is not feasible for a high-risk patient. This case report highlights the use of ultrasound technology to quantify graft health and influence treatment options. Additionally, it highlights treatment options for impending graft failure in high-risk patient populations.

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