Hybrid repair of early aortobifemoral graft occlusion in a patient with antiphospholipid syndrome: A case report: Hybrid repair of graft occlusion in APS

Laurens Vermylen; Geert Daenen; Patrick Stabel; Jo Avet; Karen Peeters

doi:10.28982/josam.8295

Authors

Laurens Vermylen Department of Vascular and Thoracic Surgery, AZ Turnhout, Turnhout, Belgium https://orcid.org/0009-0003-5649-1400
Geert Daenen Department of Vascular and Thoracic Surgery, AZ Turnhout, Turnhout, Belgium https://orcid.org/0009-0002-9795-4013
Patrick Stabel Department of Vascular and Thoracic Surgery, AZ Turnhout, Turnhout, Belgium https://orcid.org/0009-0006-4716-2009
Jo Avet Department of Vascular and Thoracic Surgery, AZ Turnhout, Turnhout, Belgium https://orcid.org/0009-0000-3058-077X
Karen Peeters Department of Vascular and Thoracic Surgery, AZ Turnhout, Turnhout, Belgium https://orcid.org/0000-0002-1166-2267

DOI:

https://doi.org/10.28982/josam.8295

Keywords:

Aortobifemoral bypass, Graft thrombosis, Hybrid procedure, Antiphospholipid syndrome

Abstract

Complete thrombosis of an aortic segment and unilateral graft limb after aortobifemoral bypass is a rare but severe complication. We report the case of a 41-year-old female patient who presented 2.5 months after aortobifemoral bypass for Leriche syndrome with recurrent claudication and ischemic rest pain. Imaging revealed complete thrombosis of the proximal aortic segment and the right iliac graft limb. A hybrid repair was performed consisting of bilateral groin incisions, thrombectomy, endarterectomy, and placement of kissing covered stents. Postoperative recovery was uneventful, with restored perfusion and good graft patency on follow-up. Thrombophilia screening demonstrated antiphospholipid syndrome, which was considered an important contributor to the early graft failure. This case illustrates that hybrid repair can be a safe and effective option for early aortobifemoral graft occlusion and highlights the importance of systemic evaluation for prothrombotic disorders in young patients presenting with unexplained thrombosis.

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