0:00

The next scan is the appearance of a bypass graft.

0:04

Here, the coverage is a chest, abdomen, pelvis,

0:09

and it's the appearance of a patent bypass graft that's

0:12

spanning across this entire z-axis.

0:16

So starting all the way at the top, and really,

0:19

run-offs can be these combination scans where

0:22

if you have an embolic source that you're looking at in the

0:25

chest, or if there is a graft. So if you look over here,

0:29

there is a vascular structure that's

0:33

enhancing, which is our

0:35

axillofemoral bypass graft right

0:38

here. That's in the subcutaneous plane and extending in the

0:42

chest and abdominal wall all the way through the side.

0:46

There's an anastomosis to the right common femoral

0:50

artery. In addition, this person also has a

0:53

femoro-femoral bypass graft right here.

0:57

So this bypass graft is essentially supplying the

1:01

inflow and outflow to the right as well as the left

1:07

lower extremity. And this is because in the setting of

1:10

an infrarenal aortic occlusion as

1:14

well and severe stenosis and bilateral common iliac artery

1:18

stenosis.

1:20

One thing that I think I may have failed to mention when we were doing our

1:25

inflow atherosclerosis disease is that there is a named syndrome when there

1:29

is an occlusion of the

1:31

infrarenal aorta and both common iliac artery.

1:34

And if you have the right

1:37

symptoms such as impotence, et cetera, then it's Leriche

1:41

syndrome that you start thinking about.

1:44

So this is what a patent axillofemoral and

1:48

femoro-femoral bypass graft looks like.

1:51

We're going to take a look at it also on a MIP section.

1:54

So right here, that's the

1:57

axillofemoral

2:01

graft on the right side, and then this right here

2:05

is the femoro-femoral bypass graft

2:08

that is spanning from one groin to the other groin.

2:12

We have to look for complications, so anything at the anastomotic

2:16

sites or within the graft.

2:19

We look for patency of the graft. These ones are widely patent and a normal scan.